Individual provider Active NPI

Ivana Hwang, OD

  • Optometrist
  • Los Gatos, CA
National Provider Identifier
1235617424
Registry record updated Jul 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34016TLG Issued in CA
Practice address
15563 Union Ave
Los Gatos, CA 95032-3904
Phone
(408) 377-2020
NPI assigned
Jul 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34016TLG CA Primary

Addresses

Primary practice location

15563 Union Ave
Los Gatos, CA 95032-3904

Mailing address

1543 Ardenwood Dr
San Jose, CA 95129-3854
Phone (408) 865-1755

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
I20181015001808 CA Practitioner - Optometry 5395097646 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34016TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Total Vision PC Optometrist CurrentSince Oct 1, 2021 Accepting new patients
Kim Khanh Nguyen OD Inc Optometrist CurrentSince Jul 6, 2022 Accepting new patients
J Pietrantonio OD Inc Optometrist PastSince Jan 1, 2005 Accepting new patients
Los Gatos Eye Care a Professional Optometric Corporation Optometrist PastSince Oct 31, 2013 Accepting new patients

Locations

338 E Hamilton Ave
Campbell, CA 95008
Phone (408) 866-2020

233 N Santa Cruz Ave
Los Gatos, CA 95030
Phone (408) 354-9310

27271 Las Ramblas
Ste 210
Mission Viejo, CA 92691

451 Blossom Hill Rd
Ste 10
San Jose, CA 95123
Phone (408) 281-3926

Organizations & group practices 4

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": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1235617424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1543 ARDENWOOD DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951293854",
            "telephone_number": "408-865-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15563 UNION AVE",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950323904",
            "telephone_number": "408-377-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HWANG",
        "first_name": "IVANA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34016TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

Verify at the official NPI Registry.