Individual provider Active NPI

Junn Cho, OD

  • Optometrist
  • Petaluma, CA
National Provider Identifier
1609596535
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
35638 Issued in CA
Practice address
1225 N McDowell Blvd
Petaluma, CA 94954-1112
Phone
(707) 559-7500
NPI assigned
Aug 31, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 009576 NY
Optometrist 152W00000X 35638 CA Primary

Addresses

Primary practice location

1225 N McDowell Blvd
Petaluma, CA 94954-1112

Mailing address

1179 N McDowell Blvd
Petaluma, CA 94954-6559
Phone (707) 559-7500

Other practice location 1

305 W 44th St
New York, NY 10036-5407
Phone (212) 586-6400

Other practice location 2

1179 N McDowell Blvd
Petaluma, CA 94954-6559
Phone (707) 559-7500

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
I20250515002499 CA Order and Referring Only - OptometryPractitioner - Optometry 5991223729

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009576NYMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: jcho817319@direct.ochin.org

NPI Registry JSON

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1609596535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1179 N MCDOWELL BLVD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546559",
            "telephone_number": "707-559-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 N MCDOWELL BLVD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949541112",
            "telephone_number": "707-559-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 W 44th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100365407",
            "country_code": "US",
            "telephone_number": "212-586-6400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1179 N McDowell Blvd",
            "address_purpose": "LOCATION",
            "city": "Petaluma",
            "state": "CA",
            "postal_code": "949546559",
            "country_code": "US",
            "telephone_number": "707-559-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHO",
        "first_name": "JUNN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-31",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009576",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

Verify at the official NPI Registry.