John Edward Fagan Jr., O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

7946T Issued in CA

Practice address

20231 W Valley Blvd
Suite G
Tehachapi, CA 93561-6748

Phone

(661) 822-1212

Fax

(661) 822-3296

NPI assigned

Aug 26, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brian K Foutch OD IncGroup PAC ID 7911483938, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Dr. John E. Fagan, Optometrist, Inc.

  • Optometrist
  • Tehachapi, CA
  • NPI 1619129921
  Medicare reassignment NPD Authorized official
• Brian K Foutch OD Inc

  • Optometrist
  • Tehachapi, CA
  • NPI 1669333464
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414713600000",
    "number": "1255324042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20231 W VALLEY BLVD",
            "address_2": "SUITE G",
            "city": "TEHACHAPI",
            "state": "CA",
            "postal_code": "935616748",
            "telephone_number": "661-822-1212",
            "fax_number": "661-822-3296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20231 W VALLEY BLVD",
            "address_2": "SUITE G",
            "city": "TEHACHAPI",
            "state": "CA",
            "postal_code": "935616748",
            "telephone_number": "661-822-1212",
            "fax_number": "661-822-3296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "JOHN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2014-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7946T",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "1688",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BL893",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1619129921",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Randi Elmore
• Hannah Emerson
• Justina Jo Engen, IBCLC
• Jasmine Nicole Enriquez
• Meghan Escoto, NP
• Brittnany Fentress
• Claire Nicole Ferguson
• Leslie Ann Figge, FNP
• Tom Finch
• Kristen Lucelia Flannigan, APCC

• Optometrist in Tehachapi, CA
• Providers in Tehachapi, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.