Individual provider Active NPI

Jackson Ma, O.D.

  • Optometrist
  • Milpitas, CA
National Provider Identifier
1740622935
Registry record updated Sep 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14691 Issued in CA
Practice address
310 Barber CT
Milpitas, CA 95035-7922
Phone
(408) 432-8101
NPI assigned
Jul 29, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 14691 CA Primary

Addresses

Primary practice location

310 Barber CT
Milpitas, CA 95035-7922

Mailing address

310 Barber CT
Milpitas, CA 95035-7922

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
I20140220000211 CA Practitioner - Optometry 4789814690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Vision PCGroup PAC ID 9234472242, 115 clinicians

Practice addresses (Care Compare)

11717 Bernardo Plaza CT
Suite 105
San Diego, CA 92128-2419
Phone (858) 487-5555

233 N Santa Cruz Ave
Los Gatos, CA 95030-7206
Phone (408) 354-9310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Total Vision PC Optometrist CurrentSince Nov 19, 2021 Accepting new patients
J Pietrantonio OD Inc Optometrist PastSince Jan 1, 2005 Accepting new patients
Steven T Klein OD & Kimberly Plattner OD a Professional Corporation Optometrist Past Accepting new patients

Locations

233 N Santa Cruz Ave
Los Gatos, CA 95030
Phone (408) 354-9310

310 Barber Ct
Unit 180
Milpitas, CA 95035
Phone (408) 432-8101

310 Barber Ct
Bldg E
Milpitas, CA 95035

310 Barber Ct
Milpitas, CA 95035
Phone (408) 342-8101

27271 Las Ramblas
Ste 210
Mission Viejo, CA 92691

11717 Bernardo Plaza Ct
Ste 105
San Diego, CA 92128
Phone (858) 487-5555

Organizations & group practices 3

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": "1375056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378684800000",
    "number": "1740622935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 BARBER CT",
            "city": "MILPITAS",
            "state": "CA",
            "postal_code": "950357922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 BARBER CT",
            "city": "MILPITAS",
            "state": "CA",
            "postal_code": "950357922",
            "telephone_number": "408-432-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MA",
        "first_name": "JACKSON",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-29",
        "last_updated": "2013-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milpitas, CA

Sources for this page

Verify at the official NPI Registry.