Individual provider Active NPI

Jaskiran Kaur

  • Student in an Organized Health Care Education/Training Program
  • Antelope, CA
National Provider Identifier
1619545241
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
7833 Scheidler Way
Antelope, CA 95843-4692
Phone
(916) 200-9708
NPI assigned
Jun 10, 2021
Last updated
Sep 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary
Optometrist 152W00000X 34964 CA

Addresses

Primary practice location

7833 Scheidler Way
Antelope, CA 95843-4692

Mailing address

7833 Scheidler Way
Antelope, CA 95843-4692
Phone (916) 200-9708

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
I20230413002976 CA Practitioner - Optometry 2062887508 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lillie Mosaddegh MD Inc CurrentSince Mar 1, 2023 Accepting new patients
Verissa Lam Optometry Corporation Optometrist CurrentSince Sep 12, 2024 Accepting new patients

Locations

100 Battery St
San Francisco, CA 94111
Phone (415) 399-1473

3251 20th Ave
Ste 219
San Francisco, CA 94132
Phone (415) 566-9199

490 Post St
Ste 1440
San Francisco, CA 94102
Phone (415) 392-4437

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1619545241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7833 SCHEIDLER WAY",
            "city": "ANTELOPE",
            "state": "CA",
            "postal_code": "958434692",
            "telephone_number": "916-200-9708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7833 SCHEIDLER WAY",
            "city": "ANTELOPE",
            "state": "CA",
            "postal_code": "958434692",
            "telephone_number": "916-200-9708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUR",
        "first_name": "JASKIRAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34964",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antelope, CA

Sources for this page

Verify at the official NPI Registry.