Individual provider Active NPI

Jasmeet Kaur Mann, O.D.

  • Optometrist
  • Ceres, CA
National Provider Identifier
1760736680
Registry record updated Jul 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14549 Issued in CA
Practice address
1901 Mitchell Rd Ste C
Ceres, CA 95307
Phone
(209) 537-8971
Fax
(209) 537-8974
NPI assigned
Oct 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 14549 CA Primary

Addresses

Primary practice location

1901 Mitchell Rd Ste C
Ceres, CA 95307

Mailing address

PO Box 186
Ceres, CA 95307-0186
Phone (209) 537-8971

Other identifiers 2

IdentifierTypeStateIssuer
5033839MedicaidCA
DB428AOtherCAMEDICARE GROUP PTAN

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
I20130315000015 CA Practitioner - Optometry 1759526015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1901 Mitchell Rd
Suite C
Ceres, CA 95307-2400
Phone (209) 537-8971

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14549CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ceres Eye Care Inc a Professional Optometric Corporation Optometrist CurrentSince Mar 2, 2020 Accepting new patients

Locations

1901 Mitchell Rd
Ste C
Ceres, CA 95307
Phone (209) 537-8971

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": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1760736680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 186",
            "city": "CERES",
            "state": "CA",
            "postal_code": "953070186",
            "telephone_number": "209-537-8971",
            "fax_number": "209-537-8974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 MITCHELL RD STE C",
            "city": "CERES",
            "state": "CA",
            "postal_code": "95307",
            "telephone_number": "209-537-8971",
            "fax_number": "209-537-8974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "JASMEET",
        "middle_name": "KAUR",
        "name_prefix": "Mrs.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-30",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5033839",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "DB428A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ceres, CA

Sources for this page

Verify at the official NPI Registry.