Individual provider Active NPI

Juleanne Clarice Regalario Dino, OD

  • Optometrist
  • San Mateo, CA
National Provider Identifier
1730866161
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT35467-TLG Issued in CA
Practice address
1100 Park PL Ste 10
San Mateo, CA 94403-7106
Phone
(650) 212-2338
NPI assigned
Jun 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT35467-TLG CA Primary

Addresses

Primary practice location

1100 Park PL Ste 10
San Mateo, CA 94403-7106

Mailing address

1100 Park PL Ste 10
San Mateo, CA 94403-7106
Phone (650) 212-2338

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
I20230713001944 CA Practitioner - Optometry 7517327265 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT35467-TLGCAMDOptometrist
35467CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lew and Liao a Professional Optometric Corp. Optometrist CurrentSince Jun 28, 2023 Accepting new patients

Locations

1100 Park Pl
Ste 10
San Mateo, CA 94403
Phone (650) 212-2338

Organizations & group practices 1

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": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1730866161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 PARK PL STE 10",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944037106",
            "telephone_number": "650-212-2338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 PARK PL STE 10",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944037106",
            "telephone_number": "650-212-2338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINO",
        "first_name": "JULEANNE CLARICE",
        "middle_name": "REGALARIO",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT35467-TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

Verify at the official NPI Registry.