Individual provider Active NPI

Emmeline Jang, O.D

  • Optometrist
  • Bronx, NY
National Provider Identifier
1184030413
Registry record updated May 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
33897 Issued in CA
Practice address
103 W Kingsbridge Rd
Bronx, NY 10468-3902
Phone
(718) 358-5900
NPI assigned
Jul 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 33897 CA Primary
Optometrist 152W00000X TUV008182 NY

Addresses

Primary practice location

103 W Kingsbridge Rd
Bronx, NY 10468-3902

Mailing address

7197 Village Pkwy
Ste D
Dublin, CA 94568-2411
Phone (925) 828-9511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180615001303 CA Practitioner - Optometry 3274751441 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV008182NYMDOptometrist
33897CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Iron Horse Optometric Group Optometrist CurrentSince May 29, 2018 Accepting new patients
Marina Optometric Center Inc Optometrist PastSince Jan 17, 2009 Accepting new patients
Salinas Optometric Center Inc Optometrist Past Accepting new patients

Locations

7197 Village Pkwy
Ste D
Dublin, CA 94568
Phone (925) 828-9511

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527724800000",
    "number": "1184030413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7197 VILLAGE PKWY",
            "address_2": "STE D",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945682411",
            "telephone_number": "925-828-9511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W KINGSBRIDGE RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104683902",
            "telephone_number": "718-358-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANG",
        "first_name": "EMMELINE",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-08",
        "last_updated": "2018-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33897",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008182",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.