Individual provider Active NPI

Yasmin Faridun Javed, OD

  • Optometrist
  • Berkeley, CA
National Provider Identifier
1750078481
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
35516 Issued in CA
Practice address
2222 Bancroft Ext
Berkeley, CA 94720-2023
Phone
(510) 642-2020
NPI assigned
Apr 21, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 35516 CA Primary

Addresses

Primary practice location

2222 Bancroft Ext
Berkeley, CA 94720-2023

Mailing address

6941 Santa Fe Canyon PL
San Diego, CA 92129-2251

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
I20230621001402 CA Practitioner - Optometry 4385002518 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2023
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

Practice addresses (Care Compare)

200 Minor Hall
Suite 384a
Berkeley, CA 94720-2020
Phone (510) 642-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35516CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Marshall B. Ketchum University CurrentSince Jul 1, 2023 Accepting new patients
Regents of the University of California at Berkeley Optometrist CurrentSince Aug 11, 2024 Accepting new patients
Marshall B. Ketchum University Optometrist CurrentSince Jul 1, 2023 Accepting new patients

Locations

5460 E La Palma Ave
Anaheim, CA 92807
Phone (714) 463-7500

200 Minor Hall
Ste 384A
Berkeley, CA 94720
Phone (510) 642-7844

3916 S Broadway
Los Angeles, CA 90037
Phone (323) 234-9137

Interoperability endpoints

  • Direct secure messaging: yjaved254946@direct-ucsfmedicalcenter.org
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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": "1682035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1750078481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6941 SANTA FE CANYON PL",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921292251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 BANCROFT EXT",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947202023",
            "telephone_number": "510-642-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVED",
        "first_name": "YASMIN",
        "middle_name": "FARIDUN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-21",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.