Individual provider Active NPI

Jasmine Wong Yumori, O.D.

  • Optometrist
  • Pomona, CA
National Provider Identifier
1427211473
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13650TLG Issued in CA
Practice address
795 E. Second Street
Suite 2
Pomona, CA 91766-2007
Phone
(909) 706-3899
Fax
(909) 469-8640
NPI assigned
Jul 9, 2008
Last updated
Nov 2, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13650TLG CA Primary
Low Vision Rehabilitation Optometrist 152WL0500X OPT13650TLG CA

Addresses

Primary practice location

795 E. Second Street
Suite 2
Pomona, CA 91766-2007

Mailing address

795 E. Second Street
Suite 2
Pomona, CA 91766-2007
Phone (909) 469-8773

Other identifiers 1

IdentifierTypeStateIssuer
CB224981OtherCAMEDICARE PTAN SO CAL

Other names 1

  • Dr. Jasmine Vu Wong Former name

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
I20090807000287 CA Practitioner - Optometry 5890848899 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Huntington Optometric CenterGroup PAC ID 7911237375, 6 clinicians

Practice addresses (Care Compare)

100 E Huntington Dr
Suite 102
Alhambra, CA 91801-1022
Phone (626) 281-1399

795 E 2ND St
Suite 2
Pomona, CA 91766-2007
Phone (909) 469-8673

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13650TLGCAMDOptometrist
OPT13650TLGCAMDLow Vision Rehabilitation Optometrist
13650CAMDGerontology Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Western University of Health Sciences CurrentSince Feb 19, 2014 Accepting new patients
Western University of Health Sciences Current Accepting new patients
Western University of Health Sciences CurrentSince Feb 19, 2014 Accepting new patients
Glendale Optometric Center Optometrist CurrentSince May 1, 2022 Accepting new patients
Huntington Optometric Center Optometrist CurrentSince May 1, 2022 Accepting new patients
Duane Decroupet OD a PC Optometrist PastSince May 1, 2022 Accepting new patients

Locations

100 E Huntington Dr
Ste 102
Alhambra, CA 91801
Phone (626) 281-1399

308 E Broadway
Glendale, CA 91205
Phone (818) 243-1300

795 E 2nd St
Pomona, CA 91766
Phone (909) 623-6116

795 E 2nd St
Ste 2
Pomona, CA 91766
Phone (909) 469-8673

795 E 2nd St
Ste 5
Pomona, CA 91766
Phone (909) 706-3877

795 E 2nd St
Ste 8
Pomona, CA 91766
Phone (909) 469-8673

8686 Haven Ave
Ste 200
Rancho Cucamonga, CA 91730
Phone (909) 706-3950

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jyumoriwong195821@direct.ochin.org

Organizations & group practices 6

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": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1427211473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "795 E. SECOND STREET",
            "address_2": "SUITE 2",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917662007",
            "telephone_number": "909-469-8773",
            "fax_number": "909-469-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 E. SECOND STREET",
            "address_2": "SUITE 2",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917662007",
            "telephone_number": "909-706-3899",
            "fax_number": "909-469-8640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUMORI",
        "first_name": "JASMINE",
        "middle_name": "WONG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13650TLG",
            "primary": true
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CA",
            "license": "OPT13650TLG",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN SO CAL",
            "identifier": "CB224981",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JASMINE",
            "last_name": "WONG",
            "middle_name": "VU",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.