Individual provider Active NPI

Yosuke Yonemasu, O.D.

  • Optometrist
  • Mission Viejo, CA
National Provider Identifier
1184777690
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12883T Issued in CA
Practice address
30 The Shops at Mission Viejo
Mission Viejo, CA 92691-6527
Phone
(949) 364-4010
Fax
(949) 364-4001
NPI assigned
Jan 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12883T CA Primary

Addresses

Primary practice location

30 The Shops at Mission Viejo
Mission Viejo, CA 92691-6527

Mailing address

6471 Thornwood St
San Diego, CA 92111-4132
Phone (858) 565-4208

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
I20071023000531 CA Practitioner - Optometry 4486740313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1890 Garnet Ave
San Diego, CA 92109-3363
Phone (858) 274-3777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12883TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Yosuke Yonemasu, O.D. Optometrist CurrentSince Aug 3, 2012 Accepting new patients

Locations

1890 Garnet Ave
San Diego, CA 92109
Phone (858) 274-3777

Organizations & group practices 1

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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184777690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6471 THORNWOOD ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921114132",
            "telephone_number": "858-565-4208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 THE SHOPS AT MISSION VIEJO",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916527",
            "telephone_number": "949-364-4010",
            "fax_number": "949-364-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YONEMASU",
        "first_name": "YOSUKE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12883T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.