Jean Yoo-Bourgoin, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

10185T Issued in CA

Practice address

1835 Newport Blvd
Ste E270
Costa Mesa, CA 92627-5014

Phone

(949) 646-4949

Fax

(949) 646-2533

NPI assigned

Feb 17, 2007

Last updated

Sep 19, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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. Jean Yoo Professional 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

University of California - School of Optometry, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Custom Eyes Optometry IncGroup PAC ID 8820008006, 2 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.

• Custom Eyes Optometry, Inc.

  • Optometrist
  • Costa Mesa, CA
  • NPI 1548472921
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1171670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505779200000",
    "number": "1457495913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 NEWPORT BLVD",
            "address_2": "STE E270",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "92627",
            "telephone_number": "949-646-4949",
            "fax_number": "949-646-2533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 NEWPORT BLVD",
            "address_2": "STE E270",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926275014",
            "telephone_number": "949-646-4949",
            "fax_number": "949-646-2533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOO-BOURGOIN",
        "first_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-17",
        "last_updated": "2017-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10185T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI (TYPE 2)",
            "identifier": "1548472921",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEAN",
            "last_name": "YOO",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Grace Sue Yi, OTD, OTR/L
• Katherine Yi, FNP
• Mi Sun Yi, D.C.
• Allan J. T. Yin, M. D.
• Vanesa Yip Malaga
• Janie Yoo, M. A.
• Debra Yopp
• Jevaughn Anthony Yorke
• Denis J Yoshii, D.O.
• Young Kim, DDS, Inc. (Welcome Dentistry & Braces)

• Optometrist in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2017; 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.