Jade Ngoc My Davis, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

11765T Issued in CA

Practice address

343 S Broadway
Los Angeles, CA 90013-1207

Phone

(213) 626-9978

Fax

(213) 628-0500

NPI assigned

May 17, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Jade Ngoc My Trinh Former name

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

Specialty

Optometry

Education

Southern California College of Optometry, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Imperial Valley Optometric CorporationGroup PAC ID 7911173588, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Imperial Valley Optometric Corporation

  dba Optom-Eyes Vision Care

  • Optometrist
  • El Centro, CA
  • NPI 1316950207
  Medicare reassignment Care Compare group NPD
• Imperial Beach Optometric Corporation

  dba Optom-Eyes Vision Care

  • Optometrist
  • El Centro, CA
  • NPI 1790249563
  Medicare reassignment NPD
• Great Eyes Optometry, Inc

  • Optometrist
  • Los Angeles, CA
  • NPI 1811172190
  Authorized official Same address or phone
• Imperial Valley Optometric Corporation

  dba Optom-Eyes Vision Care

  • Optometrist
  • El Centro, CA
  • NPI 1477444156
  NPD
• Total Vision PC

  dba Total Vision

  • Optometrist
  • San Diego, CA
  • NPI 1356813711
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457303398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 S BROADWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900131207",
            "telephone_number": "213-626-9978",
            "fax_number": "213-628-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 S BROADWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900131207",
            "telephone_number": "213-626-9978",
            "fax_number": "213-628-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JADE",
        "middle_name": "NGOC MY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11765T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0117650",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JADE",
            "last_name": "TRINH",
            "middle_name": "NGOC MY",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Evan James Davis
• Frederick A. Davis, MD
• Gena Yuvette Davis
• Gwendolyn Elizabeth Davis, LCSW
• Jacob Davis
• Jaimie N Davis, PHD, RD
• James Boyd Davis
• Jane Davis, M.D.
• Janet Davis
• Jarrade Victor Davis

• Optometrist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.