Jeffrey M Fanelli, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT 8168 TPL Issued in CA

Practice address

1817 Hamilton Ave
San Jose, CA 95725

Phone

(408) 264-1555

Fax

(408) 264-1562

NPI assigned

Apr 14, 2006

Sex

Male

Sole proprietor

No

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

Specialty

Optometry

Education

Southern California College of Optometry, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Larry R Fabian and Jeffrey M Fanelli PTRS Westside Family Vision CenteGroup PAC ID 3072542273, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Larry R Fabian & Jeffrey M Fanelli PTRS Westside Family Vision Center

  • Optometrist
  • Saratoga, CA
  • NPI 1255406690
  Medicare reassignment Care Compare group NPD
• Larry R Fabian & Jeffrey M Fannelli PTRS Westside Family Vision Center

  • Optometrist
  • San Jose, CA
  • NPI 1518061159
  NPD Authorized official

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306281600000",
    "number": "1831153881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 ARROYO SECO DR",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "95008",
            "telephone_number": "408-559-4517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 HAMILTON AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95725",
            "telephone_number": "408-264-1555",
            "fax_number": "408-264-1562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANELLI",
        "first_name": "JEFFREY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2011-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 8168 TPL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wen S Fan, DMD, MD
• Yu-Ying Fan, L.AC.
• Thomas Markus Fandel, M.D.
• James Lloyd Fandialan, M.A., LPCC 7084
• Thomas Fandre
• Chiahui Fang
• Jennifer Fang
• Katherine Fangon
• Senya Fania
• Mariam Faragallah

• Optometrist in San Jose, CA
• Providers in San Jose, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.