Individual provider Active NPI

Tera Nakano, OD

  • Optometrist
  • San Jose, CA
National Provider Identifier
1528134624
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11480 Issued in CA
Practice address
214 Jackson St
San Jose, CA 95112-3201
Phone
(408) 293-3730
NPI assigned
Nov 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11480 CA Primary

Addresses

Primary practice location

214 Jackson St
San Jose, CA 95112-3201

Mailing address

2840 Pruneridge Ave
Santa Clara, CA 95051-5651

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
I20060504000850 CA Practitioner - Optometry 7618987694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

214 Jackson St
San Jose, CA 95112-3201
Phone (408) 293-3730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11480CAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Shinmori Optometry, Inc. Optometrist CurrentSince Mar 1, 2006 Accepting new patients
Fifth Optometric Care of California Optometrist Current Accepting new patients
Fifth Optometric Care of California Optometrist CurrentSince Jul 3, 2023 Accepting new patients
Fifth Optometric Care of California Optometrist CurrentSince Jul 3, 2023 Accepting new patients

Locations

3333 Quality Dr
Rncho Cordova, CA 95670
Phone (704) 712-0564

214 Jackson St
San Jose, CA 95112
Phone (408) 293-3730

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528134624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 PRUNERIDGE AVE",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950515651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 JACKSON ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951123201",
            "telephone_number": "408-293-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKANO",
        "first_name": "TERA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.