Ailleen Jacob Dial, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

34384TLG Issued in CA

Practice address

1275 Airport Park Blvd
Ukiah, CA 95482-7400

Phone

(707) 313-8019

NPI assigned

Sep 12, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ailleen Deocadiz Jacob Former name

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

Specialty

Optometry

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nancy Park OD, IncGroup PAC ID 2163877200, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

81.61 of 100Reported as group

Quality

81.78

Promoting interoperability

74

Improvement activities

40

Cost

78.59

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nancy Park OD, Inc

  • Optometrist
  • Ukiah, CA
  • NPI 1275319485
  Medicare reassignment Care Compare group NPD
• Thomas S Tooma M D a Professional Corporation

  • Ophthalmology Physician
  • Newport Beach, CA
  • NPI 1922129865

  Optometrist

  Medicare reassignment NPD
• Thomas S Tooma M D a Professional Corporation

  • Optometrist
  • San Diego, CA
  • NPI 1215583257
  NPD
• Thomas S. Tooma, M.D. a Professional Corporation

  • Ophthalmology Physician
  • Newport Beach, CA
  • NPI 1386764983
  NPD (past)

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775865600000",
    "number": "1871143883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3792 HALFBEAK WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921243306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 AIRPORT PARK BLVD",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954827400",
            "telephone_number": "707-313-8019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3075 Health Center Dr Ste 403",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921232773",
            "country_code": "US",
            "telephone_number": "858-278-9900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAL",
        "first_name": "AILLEEN",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-12",
        "last_updated": "2026-04-11",
        "certification_date": "2026-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34384TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AILLEEN",
            "last_name": "JACOB",
            "middle_name": "DEOCADIZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Carmen Nicholas Dibenedetto, CRNA
• Gary Dicenzo

• Optometrist in Ukiah, CA
• Providers in Ukiah, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2026; 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.

Verify at the official NPI Registry.