Active NPI
Jenny S. Choi, O.D.
- Optometrist
- Costa Mesa, CA
National Provider Identifier
1356390538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 11301T
- Practice address
- 3033 Bristol St
Suite E
Costa Mesa, CA 92626-3001 - Phone
- (714) 957-2704
- Fax
- (714) 557-4492
- NPI assigned
- May 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 11301T | CA | Primary |
Addresses
Primary practice location
3033 Bristol St
Suite E
Costa Mesa, CA 92626-3001
Mailing address
3033 Bristol St
Suite E
Costa Mesa, CA 92626-3001
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WOP11301B | Other | CA | PPIN |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050525000504 | CA | Practitioner - Optometry | 1951394105 |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of California - School of Optometry, 1999
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3930 S Bristol St
Suite 207
Santa Ana, CA 92704-7431
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11301 | CA | MD | Social Worker |
| 11301T | CA | MD | Optometrist |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199491200000",
"number": "1356390538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3033 BRISTOL ST",
"address_2": "SUITE E",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926263001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3033 BRISTOL ST",
"address_2": "SUITE E",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926263001",
"telephone_number": "714-957-2704",
"fax_number": "714-557-4492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHOI",
"first_name": "JENNY",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-08",
"last_updated": "2008-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "11301T",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PPIN",
"identifier": "WOP11301B",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2008; 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.