Jeffrey Teruo Nishi, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

13973 Issued in CA

Practice address

308 E. Broadway
Glendale, CA 91205

Phone

(818) 243-1300

Fax

(818) 243-1583

NPI assigned

Jul 15, 2010

Last updated

Jul 15, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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, 2010

Medicare assignment

May accept Medicare assignment

Group practices

Huntington Optometric CenterGroup PAC ID 7911237375, 6 clinicians

Glendale Optometric CenterGroup PAC ID 2365532561, 5 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.

• Glendale Optometric Center

  • Optometrist
  • Glendale, CA
  • NPI 1801093653
  Medicare reassignment Care Compare group NPD
• Huntington Optometric Center

  • Optometrist
  • Alhambra, CA
  • NPI 1902452188
  Medicare reassignment Care Compare group NPD
• Duane Decroupet OD a PC

  dba Glendale Optometric Center

  • Optometrist
  • Glendale, CA
  • NPI 1730258476
  NPD (past)

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279152000000",
    "number": "1588977847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 E. BROADWAY",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91205",
            "telephone_number": "818-243-1300",
            "fax_number": "818-243-1583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 E. BROADWAY",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91205",
            "telephone_number": "818-243-1300",
            "fax_number": "818-243-1583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISHI",
        "first_name": "JEFFREY",
        "middle_name": "TERUO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-15",
        "last_updated": "2010-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sam N Nikou, MD
• Ashot Nikoyan
• Samira Niksefat
• Gleb Nilov, PA-C
• Nirupa Vignarajan, M.D., Inc.
• Steven Wayne Nishibayashi, MD
• Kuni Nishino, M.D.
• Nooshafarin Niv, PHD
• Niveen K Abdelmessih, MD, Inc
• Peter Kanyi Njuhi

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; 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.