Individual provider Active NPI

Jack Harold Sinow, O.D.

  • Optometrist
  • San Francisco, CA
National Provider Identifier
1700969193
Registry record updated Jan 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT5463 Issued in CA
Practice address
71 6TH St
San Francisco, CA 94103-1610
Phone
(415) 777-3626
Fax
(415) 777-3628
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT5463 CA Primary

Addresses

Primary practice location

71 6TH St
San Francisco, CA 94103-1610

Mailing address

71 6TH St
San Francisco, CA 94103-1610
Phone (415) 777-3626

Other identifiers 1

IdentifierTypeStateIssuer
SD0054630MedicaidCA

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
I20100218000323 CA Practitioner - Optometry 2466596127 Practice locations: San Francisco, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

71 6TH St
San Francisco, CA 94103-1610
Phone 4157773626540265

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT5463CAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264377600000",
    "number": "1700969193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 6TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941031610",
            "telephone_number": "415-777-3626",
            "fax_number": "415-777-3628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 6TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941031610",
            "telephone_number": "415-777-3626",
            "fax_number": "415-777-3628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SINOW",
        "first_name": "JACK",
        "middle_name": "HAROLD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2010-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT5463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0054630",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.