Individual provider Active NPI

Grant A Nakajima

  • Optometrist
  • Monterey, CA
National Provider Identifier
1841298247
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT09053T Issued in CA
Practice address
4 Harris CT
Suite B
Monterey, CA 93940-5798
Phone
(831) 375-5141
NPI assigned
Jul 8, 2005
Last updated
Apr 4, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT09053T CA Primary

Addresses

Primary practice location

4 Harris CT
Suite B
Monterey, CA 93940-5798

Mailing address

4 Harris CT
Suite B
Monterey, CA 93940-5798
Phone (831) 375-5141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080424000470 CA Practitioner - Optometry 0345328761 Practice locations: Monterey, CA
O20100930072963 CA DME Supplier - Physician - OptometristDME Supplier - Optician 7618094418 Practice locations: Monterey, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4 Harris Court
Suite B
Monterey, CA 93940-5798

4 Harris CT
Monterey, CA 93940-5798
Phone (831) 375-5141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT09053TCAMDOptometrist
9053CAMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1841298247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 HARRIS CT",
            "address_2": "SUITE B",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939405798",
            "telephone_number": "831-375-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 HARRIS CT",
            "address_2": "SUITE B",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939405798",
            "telephone_number": "831-375-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKAJIMA",
        "first_name": "GRANT",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT09053T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

Verify at the official NPI Registry.