Individual provider Active NPI

Jason Timbol Flores, O.D.

  • Optometrist
  • Fontana, CA
National Provider Identifier
1851429922
Registry record updated Apr 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12575T Issued in CA
Practice address
8381 Juniper Ave Ste 100
Fontana, CA 92335-3431
Phone
(909) 428-2020
NPI assigned
Mar 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 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 12575T CA Primary

Addresses

Primary practice location

8381 Juniper Ave Ste 100
Fontana, CA 92335-3431

Mailing address

2436 S Sultana Ave
Ontario, CA 91761-6038
Phone (909) 268-5037

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
I20051209000492 CA Practitioner - Optometry 2062433709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fontana Optometric Group IncGroup PAC ID 7911255302, 2 clinicians

Practice addresses (Care Compare)

8381 Juniper Ave
Suite 100
Fontana, CA 92335-3431
Phone (909) 428-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12575TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fontana Optometric Group, Inc. Optometrist CurrentSince May 20, 2018 Accepting new patients
20 -20 Vision Associates Optometry Optometrist Past Accepting new patients

Organizations & group practices 2

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": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1851429922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2436 S SULTANA AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917616038",
            "telephone_number": "909-268-5037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8381 JUNIPER AVE STE 100",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923353431",
            "telephone_number": "909-428-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES",
        "first_name": "JASON",
        "middle_name": "TIMBOL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12575T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.