Individual provider Active NPI

Jeffrey Dean Salman, OD

  • Optometrist
  • San Rafael, CA
National Provider Identifier
1366474413
Registry record updated Mar 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9594T Issued in CA
Practice address
1924 4TH St
San Rafael, CA 94901-2697
Phone
(415) 457-2020
Fax
(415) 457-2047
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9594T CA Primary

Addresses

Primary practice location

1924 4TH St
San Rafael, CA 94901-2697

Mailing address

1924 4TH St
San Rafael, CA 94901-2697
Phone (415) 457-2020

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL frontdesk@luminaoptometry.com Direct

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
I20081106000135 CA Practitioner - Optometry 8729147756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

35 San Anselmo Ave
San Anselmo, CA 94960-2842
Phone (415) 457-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lumina Optometry Incorporated Optometrist CurrentSince Nov 8, 2012 Accepting new patients
Nicholas Kerry & Jeffrey Salman OD Optometrist PastSince Dec 20, 1999 Accepting new patients

Locations

35 San Anselmo Ave
San Anselmo, CA 94960
Phone (415) 457-2020

1924 4th St
San Rafael, CA 94901
Phone (415) 457-2020

1924 4th St
Ste C
San Rafael, CA 94901
Phone (415) 457-2020

Organizations & group practices 2

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1366474413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 4TH ST",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012697",
            "telephone_number": "415-457-2020",
            "fax_number": "415-457-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 4TH ST",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012697",
            "telephone_number": "415-457-2020",
            "fax_number": "415-457-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALMAN",
        "first_name": "JEFFREY",
        "middle_name": "DEAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9594T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "frontdesk@luminaoptometry.com",
            "affiliation": "N",
            "endpointDescription": "Organization email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1924 4th St",
            "city": "San Rafael",
            "state": "CA",
            "country_code": "US",
            "postal_code": "949012697",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

Verify at the official NPI Registry.