Individual provider Active NPI

Jane D. Goodwin, O.D.

  • Optometrist
  • San Diego, CA
National Provider Identifier
1619082096
Registry record updated Jun 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT6936T Issued in CA
Practice address
2001 4TH Ave
San Diego, CA 92101-2303
Phone
(619) 466-1560
Fax
(619) 446-1692
NPI assigned
Aug 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT6936T CA Primary

Addresses

Primary practice location

2001 4TH Ave
San Diego, CA 92101-2303

Mailing address

2001 4TH Ave
San Diego, CA 92101-2303
Phone (619) 466-1560

Other identifiers 1

IdentifierTypeStateIssuer
SD0069360MedicaidCA

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
I20041026001181 CA Practitioner - Optometry 5698736288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

300 Fir St
San Diego, CA 92101-2327
Phone (848) 499-2600

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT6936TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc Optometrist CurrentSince Jan 16, 2003 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Optometrist CurrentSince Jan 16, 2003 Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients

Locations

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

5651 Copley Dr
Ste A
San Diego, CA 92111
Phone (858) 262-6109

300 Fir St
San Diego, CA 92101
Phone (619) 446-1586

Interoperability endpoints

  • Direct secure messaging: jgoodwin32614@sharphealthcare.direct-ci.com

Organizations & group practices 4

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1619082096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 4TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012303",
            "telephone_number": "619-466-1560",
            "fax_number": "619-446-1692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 4TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012303",
            "telephone_number": "619-466-1560",
            "fax_number": "619-446-1692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "JANE",
        "middle_name": "D.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT6936T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0069360",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.