Jeremy Evan Ensor, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

13123 Issued in CA

Practice address

284 Lafayette Cir
Lafayette, CA 94549-4379

Phone

(925) 284-1500

NPI assigned

Aug 8, 2006

Last updated

May 17, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210982400000",
    "number": "1780694125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 LAFAYETTE CIR",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945494379",
            "telephone_number": "925-284-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "284 LAFAYETTE CIR",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945494379",
            "telephone_number": "925-284-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENSOR",
        "first_name": "JEREMY",
        "middle_name": "EVAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2008-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East Bay Shoulder Clinic and Sports Rehabilitation, Inc
• Lorrie K. Eaton, D.C.
• Mary Lorraine Ehlers-Flint, PHD
• Eman Ahmed Elbeialy, PHARMD
• Krista Elder
• Barbara Epperson, PHD
• Sarah Elizabeth Eslinger, BCBA
• Catherine Evans
• Jason Colt Evans
• Kristal Evans, PTA

• Optometrist in Lafayette, CA
• Providers in Lafayette, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.