Individual provider Active NPI

Hoa Tat, OD

  • Optometrist
  • San Jose, CA
National Provider Identifier
1366411837
Registry record updated Dec 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11317T Issued in CA
Practice address
214 Jackson St
San Jose, CA 95112-3201
Phone
(408) 293-3730
Fax
(408) 293-2131
NPI assigned
Mar 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11317T CA Primary

Addresses

Primary practice location

214 Jackson St
San Jose, CA 95112-3201

Mailing address

214 Jackson St
San Jose, CA 95112-3201
Phone (408) 293-3730

Other identifiers 1

IdentifierTypeStateIssuer
GR0022890MedicaidCA

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
I20070515000618 CA Practitioner - Optometry 6305943986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fifth Optometric Care of CaliforniaGroup PAC ID 4284096298, 22 clinicians

Practice addresses (Care Compare)

214 Jackson St
San Jose, CA 95112-3201
Phone (408) 293-3730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11317TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fifth Optometric Care of California Optometrist CurrentSince Jul 11, 2023 Accepting new patients
Fifth Optometric Care of California Optometrist Current Accepting new patients
Shinmori Optometry, Inc. Optometrist CurrentSince Mar 20, 2007 Accepting new patients
Fifth Optometric Care of California Optometrist CurrentSince Jul 11, 2023 Accepting new patients

Locations

3333 Quality Dr
Rncho Cordova, CA 95670
Phone (704) 712-0564

214 Jackson St
San Jose, CA 95112
Phone (408) 293-3730

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292371200000",
    "number": "1366411837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 JACKSON ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951123201",
            "telephone_number": "408-293-3730",
            "fax_number": "408-293-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 JACKSON ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951123201",
            "telephone_number": "408-293-3730",
            "fax_number": "408-293-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAT",
        "first_name": "HOA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2010-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11317T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0022890",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.