Individual provider Active NPI

Jeremy Cheung, OD

  • Optometrist
  • Santa Clara, CA
National Provider Identifier
1437641081
Registry record updated Dec 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34079TLG Issued in CA
Practice address
710 Lawrence Expy
Santa Clara, CA 95051-5173
Phone
(408) 851-1000
NPI assigned
May 30, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34079TLG CA Primary

Addresses

Primary practice location

710 Lawrence Expy
Santa Clara, CA 95051-5173

Mailing address

1032 Irving St # 928
San Francisco, CA 94122-2216
Phone (415) 350-7290

Other practice location 1

3710 SW US Veterans Hospital Rd
Portland, OR 97239-2964
Phone (503) 220-8262

Other practice location 2

495 Castro St
Mountain View, CA 94041-2086
Phone (650) 967-6649

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

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
I20191216002396 CA Practitioner - Optometry 3072947597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

710 Lawrence Express Way
Santa Clara, CA 95051-5173
Phone (408) 851-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34079CAMDGeneral Practice Dentistry
34079TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc CurrentSince Sep 12, 2022 Accepting new patients
Permanente Medical Group Inc Current Accepting new patients
Mountain View Optometry and Contact Lens Clinic Optometrist CurrentSince Sep 27, 2019 Accepting new patients
Permanente Medical Group, Inc CurrentSince Sep 12, 2022 Accepting new patients
Fourth Optometric Care of California Optometrist CurrentSince Apr 24, 2022 Accepting new patients
Jon G. Wada, O.D. Optometrist Past Accepting new patients
Fourth Optometric Care of California Optometrist PastSince Nov 1, 2019 Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

495 Castro St
Ste 200
Mountain View, CA 94041
Phone (650) 967-6649

495 Castro St
Mountain View, CA 94041
Phone (650) 957-6649

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Organizations & group practices 7

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": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1437641081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1032 IRVING ST # 928",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941222216",
            "telephone_number": "415-350-7290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 LAWRENCE EXPY",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950515173",
            "telephone_number": "408-851-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3710 SW US Veterans Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972392964",
            "country_code": "US",
            "telephone_number": "503-220-8262",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "495 Castro St",
            "address_purpose": "LOCATION",
            "city": "Mountain View",
            "state": "CA",
            "postal_code": "940412086",
            "country_code": "US",
            "telephone_number": "650-967-6649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEUNG",
        "first_name": "JEREMY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-30",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34079TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "710 Lawrence Expy",
            "city": "Santa Clara",
            "state": "CA",
            "country_code": "US",
            "postal_code": "950515173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Clara, CA

Sources for this page

Verify at the official NPI Registry.