Individual provider Active NPI

Jennifer Leigh Bartlett, OPTICIAN

  • Optician
  • San Jose, CA
National Provider Identifier
1417258187
Registry record updated Nov 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
SL6311 Issued in CA
Practice address
2516 Samaritan Dr
Suite E
San Jose, CA 95124-4108
Phone
(408) 358-8223
NPI assigned
Nov 10, 2010
Last updated
Nov 10, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X SL6311 CA Primary

Addresses

Primary practice location

2516 Samaritan Dr
Suite E
San Jose, CA 95124-4108

Mailing address

2516 Samaritan Dr
Suite E
San Jose, CA 95124-4108
Phone (408) 358-8223

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SL6311CAMDOptician

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": "1289347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289347200000",
    "number": "1417258187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2516 SAMARITAN DR",
            "address_2": "SUITE E",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244108",
            "telephone_number": "408-358-8223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2516 SAMARITAN DR",
            "address_2": "SUITE E",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244108",
            "telephone_number": "408-358-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTLETT",
        "first_name": "JENNIFER",
        "middle_name": "LEIGH",
        "name_prefix": "Miss",
        "credential": "OPTICIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-10",
        "last_updated": "2010-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "CA",
            "license": "SL6311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2010; 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.