Individual provider Active NPI

Jennifer G Bartolome Optometry Corp, O.D.

  • Optometrist
  • Studio City, CA
National Provider Identifier
1669635413
Registry record updated Jul 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13498 Issued in CA
Practice address
10977 Ventura Blvd
Studio City, CA 91604-3341
Phone
(818) 763-6666
NPI assigned
Jul 2, 2008
Last updated
Jul 22, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13498 CA Primary
Corneal and Contact Management Optometrist 152WC0802X 13498 CA

Addresses

Primary practice location

10977 Ventura Blvd
Studio City, CA 91604-3341

Mailing address

10977 Ventura Blvd
Studio City, CA 91604-3341
Phone (818) 763-6666

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
I20110124001126 CA Practitioner - Optometry 3173702032 Practice locations: Brea, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer G. Bartolome Optometry Corp Optometrist Past Accepting new patients
Luxottica of America Inc. Past Accepting new patients
Luxottica of America Inc Past Accepting new patients

Organizations & group practices 3

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": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437523200000",
    "number": "1669635413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10977 VENTURA BLVD",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916043341",
            "telephone_number": "818-763-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10977 VENTURA BLVD",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916043341",
            "telephone_number": "818-763-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTOLOME OPTOMETRY CORP",
        "first_name": "JENNIFER",
        "middle_name": "G",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2015-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13498",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "13498",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Studio City, CA

Sources for this page

Verify at the official NPI Registry.