Individual provider Active NPI

Jason H Nakagawa, O.D

  • Optometrist
  • Culver City, CA
National Provider Identifier
1861415481
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OP9916 Issued in CA
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

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
OP9916CAMDOptometrist

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

Verify at the official NPI Registry.