Individual provider Active NPI

Jerome Splan, O.D.

  • Optometrist
  • Granada Hills, CA
National Provider Identifier
1366416281
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4464T Issued in CA
Practice address
16970 San Fernando Mission Blvd
Granada Hills, CA 91344-4259
Phone
(818) 360-7522
Fax
(818) 363-8859
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4464T CA Primary

Addresses

Primary practice location

16970 San Fernando Mission Blvd
Granada Hills, CA 91344-4259

Mailing address

16970 San Fernando Mission Blvd
Granada Hills, CA 91344-4259
Phone (818) 360-7522

Other identifiers 1

IdentifierTypeStateIssuer
SD0044640MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4464TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Hovhannes Hovhannisyan, OD, Inc Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1366416281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16970 SAN FERNANDO MISSION BLVD",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913444259",
            "telephone_number": "818-360-7522",
            "fax_number": "818-363-8859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16970 SAN FERNANDO MISSION BLVD",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913444259",
            "telephone_number": "818-360-7522",
            "fax_number": "818-363-8859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPLAN",
        "first_name": "JEROME",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "4464T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0044640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Granada Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.