Active NPI
Jon H Yamane, OD
- Optometrist
- Huntington Beach, CA
National Provider Identifier
1417927047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 12380TPL
- Practice address
- 18685 Main St
Ste E
Huntington Beach, CA 92648 - Phone
- (714) 847-1271
- Fax
- (714) 362-9533
- NPI assigned
- Jan 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 12380TPL | CA | Primary |
Addresses
Primary practice location
18685 Main St
Ste E
Huntington Beach, CA 92648
Mailing address
1545 Nutmeg PL
Costa Mesa, CA 92626-2560
Phone (714) 847-1271
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5582835 | Medicaid | CA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1545 Nutmeg PL
Costa Mesa, CA 92626-2503
Phone (714) 847-1271
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12380TPL | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jon H. Yamane, O.D., Inc. | Optometrist | Current | Accepting new patients |
| Richard J. Miyamoto, O.D | Optometrist | Past | Accepting new patients |
Locations
1545 Nutmeg Pl
Costa Mesa, CA 92626
Phone (714) 435-1150
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Optometrist
- Huntington Beach, CA
- NPI 1730432865
-
- Optometrist
- Gardena, CA
- NPI 1427185990
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524614400000",
"number": "1417927047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1545 NUTMEG PL",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926262560",
"telephone_number": "714-847-1271",
"fax_number": "714-362-9533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18685 MAIN ST",
"address_2": "STE E",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "92648",
"telephone_number": "714-847-1271",
"fax_number": "714-362-9533"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAMANE",
"first_name": "JON",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-25",
"last_updated": "2018-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "12380TPL",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5582835",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Huntington Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.