Jeffrey Phillip Wasserstrom, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

G54813 Issued in CA

Practice address

5565 Grossmont Center Dr
BLDG. 3 Suite 551
La Mesa, CA 91942-3020

Phone

(619) 698-1088

Fax

(619) 698-1189

NPI assigned

Jun 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Trilogy Eye Medical Group Inc

  • Ophthalmology Physician
  • Pasadena, CA
  • NPI 1114205432
  NPD

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391644800000",
    "number": "1710922687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5565 GROSSMONT CENTER DR",
            "address_2": "BLDG. 3 SUITE 551",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423020",
            "telephone_number": "619-698-1088",
            "fax_number": "619-698-1189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5565 GROSSMONT CENTER DR",
            "address_2": "BLDG. 3 SUITE 551",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423020",
            "telephone_number": "619-698-1088",
            "fax_number": "619-698-1189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSERSTROM",
        "first_name": "JEFFREY",
        "middle_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2014-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G54813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G548130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joyce Wang, M.D.
• Jeffrey Wannares
• Katherine Ward, APRN, FNP-C
• Shanna Wardhaugh
• Lindsay Marie Warner
• Carol L Watkins, MS, LMFT
• Rebecca Watson, BSW
• Ronald M Watson, O.D.
• Sandra Sue Watt, L.AC.
• Shaney Alynne Watters, MFT

• Ophthalmology Physician in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.