Individual provider Active NPI

Nicole Monica Janovitch, O.D.

  • Optometrist
  • Sunnyvale, CA
National Provider Identifier
1720133036
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12056T Issued in CA
Practice address
1210 E Arques Ave
Suite 210
Sunnyvale, CA 94085-5421
Phone
(408) 245-2020
Fax
(408) 245-2520
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12056T CA Primary

Addresses

Primary practice location

1210 E Arques Ave
Suite 210
Sunnyvale, CA 94085-5421

Mailing address

1210 E Arques Ave
Suite 210
Sunnyvale, CA 94085-5421
Phone (408) 245-2020

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
I20050520000490 CA Practitioner - Optometry 2062453301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fyidoctors of California IncGroup PAC ID 3577961572, 21 clinicians

Practice addresses (Care Compare)

1039 El Monte Ave
Suite K
Mountain View, CA 94040-2371
Phone (650) 967-0140

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12056TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fyidoctors of California, Inc. Optometrist CurrentSince Nov 28, 2023 Accepting new patients
Brent P. Chinn, OD and David M. Redman, OD, Optometric Group, Inc Optometrist CurrentSince Nov 28, 2023 Accepting new patients

Locations

1039 El Monte Ave
Ste K
Mountain View, CA 94040
Phone (650) 967-0140

114 N Sunrise Ave
Ste C4
Roseville, CA 95661
Phone (916) 786-2212

117 Bernal Rd
Ste 40
San Jose, CA 95119
Phone (408) 362-9789

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720133036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 E ARQUES AVE",
            "address_2": "SUITE 210",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940855421",
            "telephone_number": "408-245-2020",
            "fax_number": "408-245-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 E ARQUES AVE",
            "address_2": "SUITE 210",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940855421",
            "telephone_number": "408-245-2020",
            "fax_number": "408-245-2520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANOVITCH",
        "first_name": "NICOLE",
        "middle_name": "MONICA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12056T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, CA

Sources for this page

Verify at the official NPI Registry.