NPIMap

Organization Active NPI

Jenifer E L Webb OD, Inc.

  • Optometrist
  • Mountain View, CA
National Provider Identifier
1245092527
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
JENIFER E L WEBB OD, INC.
Practice address
419 N Shoreline Blvd
Mountain View, CA 94043-4605
Phone
(652) 096-7578
Fax
(650) 967-4106
NPI assigned
Jan 23, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Authorized official

Name
Jenifer E L Webb, ODNPI 1306045869
Title
Owner
Phone
(650) 967-5789

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

419 N Shoreline Blvd
Mountain View, CA 94043-4605

Mailing address

419 N Shoreline Blvd
Mountain View, CA 94043-4605
Phone (650) 967-5789

Other names 1

  • Shoreline Optometry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240322002806 CA Part B Supplier - Clinic/Group Practice 6406293653 Receives reassigned benefits from 4 practitioners
Practice locations: Mountain View, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1705968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706572800000",
    "number": "1245092527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 N SHORELINE BLVD",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940434605",
            "telephone_number": "650-967-5789",
            "fax_number": "650-967-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 N SHORELINE BLVD",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940434605",
            "telephone_number": "652-096-7578",
            "fax_number": "650-967-4106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENIFER E L WEBB OD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "WEBB",
        "authorized_official_first_name": "JENIFER",
        "authorized_official_middle_name": "E L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-967-5789",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shoreline Optometry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shoreline Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mountain View, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.