Jennifer Djie Witkowski, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

10270 T Issued in CA

Practice address

1760 S Pacific Coast Hwy
Redondo Beach, CA 90277-5902

Phone

(310) 540-2970

Fax

(310) 540-1312

NPI assigned

Jan 16, 2007

Sex

Female

Sole proprietor

No

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 College of Optometry, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jennifer Djie Witkowski, O.D. a Professional CorporationGroup PAC ID 6507307535, 2 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 and National Provider Directory roles.

• Jennifer Djie Witkowski, O.D. a Professional Corporation

  • Optometrist
  • Redondo Beach, CA
  • NPI 1053818385
  Medicare reassignment Care Compare group NPD Authorized official
• Healthcare Partners Affiliates Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593
  NPD (past)

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619028453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4937 MINTURN AVE",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907123113",
            "telephone_number": "562-529-6023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 S PACIFIC COAST HWY",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775902",
            "telephone_number": "310-540-2970",
            "fax_number": "310-540-1312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITKOWSKI",
        "first_name": "JENNIFER",
        "middle_name": "DJIE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10270 T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Gulyas Wintrode, LMFT
• Glen Wishon, M.D.
• Athur L. Wisot, M.D.
• Abigail Withee, MFT
• Withrow Out a Trace Ministyr
• Madeline Elaine Witthuhn, AMFT
• Joshua Wohlgemuth, D.D.S.
• Carolyn Wolfe, SLPA
• Mara Joanna Wolfsen, LCSW
• Fredrick Nathaniel Wolk, M.D.

• Optometrist in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.