Active NPI
Jason H Nakagawa, O.D
- Optometrist
- Culver City, CA
National Provider Identifier
1861415481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OP9916
- Practice address
- 6000 Hannum Ave
Culver City, CA 90230-6504 - Phone
- (310) 398-6900
- Fax
- (310) 390-8449
- NPI assigned
- Jul 25, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OP9916 | CA | Primary |
Addresses
Primary practice location
6000 Hannum Ave
Culver City, CA 90230-6504
Mailing address
6000 Hannum Ave
Culver City, CA 90230-6504
Phone (310) 365-4802
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051216000733 | CA | Practitioner - Optometry | 7810918836 | Practice locations: Marina del Rey, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pacific University - College of Optometry, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4560 Admiralty Way
Suite 354
Marina del Rey, CA 90292-5449
Phone (310) 508-4348
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OP9916 | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861415481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6000 HANNUM AVE",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902306504",
"telephone_number": "310-365-4802",
"fax_number": "310-390-8449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6000 HANNUM AVE",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902306504",
"telephone_number": "310-398-6900",
"fax_number": "310-390-8449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAKAGAWA",
"first_name": "JASON",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "O.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "OP9916",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Culver City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.