Individual provider Active NPI

Jennifer Zhao, OD

  • Optometrist
  • Pleasanton, CA
National Provider Identifier
1245927748
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT35397-TLG Issued in CA
Practice address
5575 W Las Positas Blvd Ste 240
Pleasanton, CA 94588-5803
Phone
(925) 460-5000
NPI assigned
Apr 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT35397-TLG CA Primary

Addresses

Primary practice location

5575 W Las Positas Blvd Ste 240
Pleasanton, CA 94588-5803

Mailing address

3743 Fairlands Dr
Pleasanton, CA 94588-3418

Other practice location 1

28 Fenton St
Livermore, CA 94550-4144
Phone (925) 449-4000

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
I20230606002860 CA Practitioner - Optometry 4981061942 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gagnon Vision Medical Group IncGroup PAC ID 6103054937, 7 clinicians

Practice addresses (Care Compare)

5575 W Las Positas Blvd
Suite 240
Pleasanton, CA 94588-5803
Phone (925) 460-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35397CAMDPsychologist
OPT35397-TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyevue Optometry, Inc. Optometrist CurrentSince May 31, 2023 Accepting new patients
Gagnon Vision Medical Group Inc Optometrist CurrentSince Sep 2, 2024 Accepting new patients
Gagnon Vision Medical Group Inc Optometrist CurrentSince Sep 2, 2024 Accepting new patients
El Camino Hospital PastSince May 31, 2023 Accepting new patients

Locations

28 Fenton St
Livermore, CA 94550
Phone (925) 449-4000

61 Serra Way
Ste 128
Milpitas, CA 95035
Phone (408) 262-8998

5575 W Las Positas Blvd
Ste 240
Pleasanton, CA 94588
Phone (925) 460-5000

Interoperability endpoints

  • Direct secure messaging: jzhao@vecma.intellechartdirect.net

Organizations & group practices 5

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": "1682294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1245927748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3743 FAIRLANDS DR",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945883418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5575 W LAS POSITAS BLVD STE 240",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945885803",
            "telephone_number": "925-460-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28 Fenton St",
            "address_purpose": "LOCATION",
            "city": "Livermore",
            "state": "CA",
            "postal_code": "945504144",
            "country_code": "US",
            "telephone_number": "925-449-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZHAO",
        "first_name": "JENNIFER",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-24",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT35397-TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.