Active NPI
Jane D. Goodwin, O.D.
- Optometrist
- San Diego, CA
National Provider Identifier
1619082096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT6936T
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0069360 | Medicaid | CA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 Inc
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 100
- Quality
- 81.04
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 82.04
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT6936T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sharp Rees-Stealy Medical Group, Inc | Optometrist | Current | Accepting new patients |
| Sharp Rees-Stealy Medical Group, Inc | Optometrist | Current | 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
- 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.
-
- Internal Medicine Physician
- San Diego, CA
- NPI 1285616177
CA, Optometrist
-
- Optometrist
- San Diego, CA
- NPI 1063172351
-
- Rehabilitation Hospital Unit
- San Diego, CA
- NPI 1114901352
-
- Physical Therapist
- Chula Vista, CA
- NPI 1407096589
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2013; 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.