Jack Thomas Holden

Primary specialty

OptometristTaxonomy code 152W00000X

License

35372 Issued in CA

Practice address

1545 W 5TH St Ste 100
Oxnard, CA 93030-6510

Phone

(805) 382-2020

NPI assigned

Dec 20, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Dean Amundsen,O.D. Professional Optometry Corp.

  • Optometrist
  • Camarillo, CA
  • NPI 1750353637
  Medicare reassignment NPD

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

{
    "created_epoch": "1671494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1487366571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 W 5TH ST STE 100",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930306510",
            "telephone_number": "805-382-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 W 5TH ST STE 100",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930306510",
            "telephone_number": "805-382-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDEN",
        "first_name": "JACK",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-20",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Calyn Bao Tram Hoang, DMD
• Hannah Hoang, DMD
• Sierra Lynn Hofman
• Sandina Lisa Hohan
• Holden OD & Knapp OD
• Patrick Jacob Holden, OD
• Holistic Health, a Nursing Professional Corporation
• Robyn Mackay Holmberg
• Cristina Nicole Holmes
• Sarah Katherine Holmgren, PT, DPT

• Optometrist in Oxnard, CA
• Providers in Oxnard, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; 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.