Individual provider Active NPI

Jay Paul Kaze, O.D.

  • Optometrist
  • Roseville, CA
National Provider Identifier
1841225497
Registry record updated Jul 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT10070TPA Issued in CA
Practice address
206 Sharon Way
Roseville, CA 95678-2332
Phone
(916) 208-0155
Fax
(916) 774-9885
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT10070TPA CA Primary

Addresses

Primary practice location

206 Sharon Way
Roseville, CA 95678-2332

Mailing address

206 Sharon Way
Roseville, CA 95678-2332
Phone (916) 208-0155

Other identifiers 1

IdentifierTypeStateIssuer
SD0100701MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10070CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310947200000",
    "number": "1841225497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 SHARON WAY",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956782332",
            "telephone_number": "916-208-0155",
            "fax_number": "916-774-9885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 SHARON WAY",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956782332",
            "telephone_number": "916-208-0155",
            "fax_number": "916-774-9885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZE",
        "first_name": "JAY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2011-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT10070TPA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0100701",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.