Jeffrey Joseph Kong, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

34996TLG Issued in CA

Practice address

230 Minor Hall MC-2020
Berkeley, CA 94720-2020

Phone

(510) 642-2020

Fax

(510) 642-8012

NPI assigned

Jul 8, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX, CA2 enrollments

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 2

Specialty

Optometry

Education

University of California - School of Optometry, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Regents of the University of California at BerkeleyGroup PAC ID 8628083110, 57 clinicians

Alameda Health SystemGroup PAC ID 3779494521, 597 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkong349734@direct-ucsfmedicalcenter.org
• Direct secure messaging: jkong72060@alamedahs.direct-ci.com

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.

• Alameda Health System

  • Surgery Physician
  • Oakland, CA
  • NPI 1740332931
  Medicare reassignment Care Compare group NPD
• Regents of the University of California at Berkeley

  • Optometrist
  • Berkeley, CA
  • NPI 1306908058
  Medicare reassignment Care Compare group NPD
• University of Houston System

  • Optometrist
  • Houston, TX
  • NPI 1861493140
  Medicare reassignment NPD
• Alameda Health System

  • Federally Qualified Health Center (FQHC)
  • Hayward, CA
  • NPI 1023219821
  NPD
• Alameda Health System

  • Federally Qualified Health Center (FQHC)
  • Newark, CA
  • NPI 1497956288
  NPD
• University of Houston

  • Community Health Worker
  • Houston, TX
  • NPI 1366081622
  NPD
• Alameda Health System

  • General Acute Care Hospital
  • Oakland, CA
  • NPI 1083815872
  NPD (past)

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659744000000",
    "number": "1730750985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 W HILLVIEW CT",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "950203753",
            "telephone_number": "408-310-1271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 MINOR HALL MC-2020",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947202020",
            "telephone_number": "510-642-2020",
            "fax_number": "510-642-8012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONG",
        "first_name": "JEFFREY",
        "middle_name": "JOSEPH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-08",
        "last_updated": "2022-08-06",
        "certification_date": "2022-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10356",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34996TLG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "426300601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "10356",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "34996TLG",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsey Koida, DDS
• John Kokko, L.AC.
• Tara Collins Kolar, PSYD
• Rebecca Krow-Boniske Kolta, DPT
• Nadya Kondrashov, M.D.
• Laura Kong, D.M.D
• Roger Lewis Koppel, D.D.S.
• Touraj Kormi, MD
• Deborah Kory, PSYD
• Elizabeth Marie-Jane Korza, N.D.

• Optometrist in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.