Individual provider Active NPI

Jennifer Ann Gilman Vorster, O.D.

  • Optometrist
  • Indio, CA
National Provider Identifier
1760562813
Registry record updated Jul 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12255 Issued in CA
Practice address
81833 Doctor Carreon Blvd Ste 5
Indio, CA 92201-5590
Phone
(760) 863-2241
Fax
(760) 863-1919
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12255 CA Primary

Addresses

Primary practice location

81833 Doctor Carreon Blvd Ste 5
Indio, CA 92201-5590

Mailing address

81833 Doctor Carreon Blvd Ste 5
Indio, CA 92201-5590
Phone (760) 863-2241

Other identifiers 1

IdentifierTypeStateIssuer
SD0122550MedicaidCA

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
I20060217000259 CA Practitioner - Optometry 2365457066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gilman and Vorster Optometry, IncGroup PAC ID 5092720797, 2 clinicians

Practice addresses (Care Compare)

81833 Doctor Carreon Blvd
Suite 5
Indio, CA 92201-5590
Phone (760) 863-2241

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12255CAMDProfessional Counselor
2706AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gilman & Vorster Optometry, Inc Optometrist CurrentSince Feb 15, 2006 Accepting new patients

Locations

81833 Doctor Carreon Blvd
Ste 5
Indio, CA 92201
Phone (760) 863-2241

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406246400000",
    "number": "1760562813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81833 DOCTOR CARREON BLVD STE 5",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015590",
            "telephone_number": "760-863-2241",
            "fax_number": "760-863-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81833 DOCTOR CARREON BLVD STE 5",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015590",
            "telephone_number": "760-863-2241",
            "fax_number": "760-863-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMAN VORSTER",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2014-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0122550",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indio, CA

Sources for this page

Verify at the official NPI Registry.