John C Pack, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

9684T Issued in CA

Practice address

374 E H St
Ste 1708
Chula Vista, CA 91910-7484

Phone

(619) 425-7990

Fax

(619) 425-7992

NPI assigned

May 2, 2006

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

Other identifiers 3

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

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Total Vision PCGroup PAC ID 9234472242, 115 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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 and National Provider Directory roles.

• Total Vision PC

  • Optometrist
  • San Diego, CA
  • NPI 1356813711
  Medicare reassignment Care Compare group NPD
• Bonita Point Family Optometry, Inc.

  • Optometrist
  • Bonita, CA
  • NPI 1265637714
  NPD (past)
• Steven T Klein OD & Kimberly Plattner OD a Professional Corporation

  • Optometrist
  • San Diego, CA
  • NPI 1861529703
  NPD (past)

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1598723587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 E H ST",
            "address_2": "STE 1708",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919107484",
            "telephone_number": "619-425-7990",
            "fax_number": "619-425-7992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 E H ST",
            "address_2": "STE 1708",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919107484",
            "telephone_number": "619-425-7990",
            "fax_number": "619-425-7992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACK",
        "first_name": "JOHN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9684T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "200547724",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IMED",
            "identifier": "912870",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0096840",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pacific Coast Referral Services
• Pacific Pointe
• Pacific Rim Pathology Medical Corporation
• Pacifica Bonita LP
• Alyssa Teresa Pack
• Todd Webster Pacofsky, DMD
• Florence Agagas Pacrem, RN
• Yolanda Paderes
• Daisy Padilla Flores
• Analilia Padilla-Corona, RD

• Optometrist in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.