Individual provider Active NPI

Mindy Minh-Nguyet Walker, O.D.

  • Optometrist
  • San Jose, CA
National Provider Identifier
1609890417
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12129T Issued in CA
Practice address
2690 S White Rd Ste 255
San Jose, CA 95148-2098
Phone
(408) 274-9090
Fax
(408) 274-9120
NPI assigned
Jul 26, 2006
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 12129T CA Primary

Addresses

Primary practice location

2690 S White Rd Ste 255
San Jose, CA 95148-2098

Mailing address

2690 S White Rd Ste 255
San Jose, CA 95148-2098
Phone (408) 274-9090

Other identifiers 1

IdentifierTypeStateIssuer
12129TOtherCALICENSE NUMBER

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
I20080115000882 CA Practitioner - Optometry 4284715244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1998
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)

233 N Santa Cruz Ave
Los Gatos, CA 95030-7206
Phone (408) 354-9310

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12129TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Total Vision PC Optometrist CurrentSince Apr 1, 2021 Accepting new patients
J Pietrantonio OD Inc Optometrist PastSince Jan 1, 2005 Accepting new patients

Locations

233 N Santa Cruz Ave
Los Gatos, CA 95030
Phone (408) 354-9310

27271 Las Ramblas
Ste 210
Mission Viejo, CA 92691

27271 Las Ramblas
Ste 200
Mission Viejo, CA 92691
Phone (949) 651-7236

2690 S White Rd
Ste 255
San Jose, CA 95148
Phone (408) 274-9090

8205 Santa Monica Blvd
Ste 15
West Hollywood, CA 90046
Phone (323) 650-0337

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609890417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2690 S WHITE RD STE 255",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951482098",
            "telephone_number": "408-274-9090",
            "fax_number": "408-274-9120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2690 S WHITE RD STE 255",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951482098",
            "telephone_number": "408-274-9090",
            "fax_number": "408-274-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "MINDY",
        "middle_name": "MINH-NGUYET",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12129T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "12129T",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.