Individual provider Active NPI

Joe A. Vargas, O.D.

  • Optometrist
  • Ukiah, CA
National Provider Identifier
1407910375
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10744T Issued in CA
Practice address
789 S Dora St
Ukiah, CA 95482-5335
Phone
(707) 462-8363
Fax
(707) 462-8366
NPI assigned
Dec 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10744T CA Primary

Addresses

Primary practice location

789 S Dora St
Ukiah, CA 95482-5335

Mailing address

789 S Dora St
Ukiah, CA 95482-5335
Phone (707) 462-8363

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
I20101228000432 CA Practitioner - Optometry 5698963163 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joe a Vargas O D Professional CorporationGroup PAC ID 2567650039, 2 clinicians

Practice addresses (Care Compare)

789 S Dora St
Ukiah, CA 95482-5335
Phone (707) 462-8363

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10744TCAMDOptometrist
10744CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Joe a Vargas O D Professional Corporation Optometrist CurrentSince Oct 3, 2010 Accepting new patients

Locations

789 S Dora St
Ukiah, CA 95482
Phone (707) 462-8363

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": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1407910375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "789 S DORA ST",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954825335",
            "telephone_number": "707-462-8363",
            "fax_number": "707-462-8366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 S DORA ST",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954825335",
            "telephone_number": "707-462-8363",
            "fax_number": "707-462-8366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "JOE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10744T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ukiah, CA

Sources for this page

Verify at the official NPI Registry.