Individual provider Active NPI

John M Neishi, O.D.

  • Optometrist
  • San Leandro, CA
National Provider Identifier
1528033875
Registry record updated Feb 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8819T Issued in CA
Practice address
15070 Hesperian Blvd
Suite G
San Leandro, CA 94578-3546
Phone
(510) 276-8420
Fax
(510) 276-6669
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8819T CA Primary

Addresses

Primary practice location

15070 Hesperian Blvd
Suite G
San Leandro, CA 94578-3546

Mailing address

15070 Hesperian Blvd
Suite G
San Leandro, CA 94578-3546
Phone (510) 276-8420

Other identifiers 2

IdentifierTypeStateIssuer
0269570001OtherNSC
SD0088190MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266969600000",
    "number": "1528033875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15070 HESPERIAN BLVD",
            "address_2": "SUITE G",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945783546",
            "telephone_number": "510-276-8420",
            "fax_number": "510-276-6669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15070 HESPERIAN BLVD",
            "address_2": "SUITE G",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945783546",
            "telephone_number": "510-276-8420",
            "fax_number": "510-276-6669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEISHI",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2010-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8819T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC",
            "identifier": "0269570001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0088190",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

Verify at the official NPI Registry.