Jordan M Usunov, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

C38780 Issued in CA

Practice address

1540 N Tracy Blvd
A
Tracy, CA 95376-2903

Phone

(209) 836-2223

Fax

(209) 836-2530

NPI assigned

Dec 18, 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 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Jordan M Usunov M D a Professional Corporation

  • Ophthalmology Physician
  • Tracy, CA
  • NPI 1154511442
  NPD Authorized official

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201737600000",
    "number": "1609939099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 N TRACY BLVD",
            "address_2": "A",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953762903",
            "telephone_number": "209-836-2223",
            "fax_number": "209-836-2530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 N TRACY BLVD",
            "address_2": "A",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953762903",
            "telephone_number": "209-836-2223",
            "fax_number": "209-836-2530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "USUNOV",
        "first_name": "JORDAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2008-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "C38780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DOC387801",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Manreet Uppal
• Clifford Wayne Upshaw
• Billy Urbano, M.D.
• Wivina Talabis Urbano, M.D.
• Samantha Uribe
• Gianna Utzerath
• Alan Tadao Uyeno, MD
• VA Palo Altohealth Care Systems Facility
• Khosrow Vakhshouri, M.D.
• Adrian Valadez

• Ophthalmology Physician in Tracy, CA
• Providers in Tracy, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.