Jared Hagan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

14385TLG Issued in CA

Practice address

4822 Newport Ave
San Diego, CA 92107-3111

Phone

(509) 869-5926

NPI assigned

Oct 7, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Pacific University - College of Optometry, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Newport Avenue Optometry IncGroup PAC ID 1355770058, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• Newport Avenue Optometry Inc.

  • Optometrist
  • San Diego, CA
  • NPI 1306497888
  Medicare reassignment Care Compare group NPD
• Jared Hagan Optometry

  • Optometrist
  • San Diego, CA
  • NPI 1396160479
  NPD (past) Authorized official
• Steven T Klein OD & Kimberly Plattner OD a Professional Corporation

  • Optometrist
  • San Diego, CA
  • NPI 1861529703
  NPD (past)

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

{
    "created_epoch": "1254873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1881929966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4822 NEWPORT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921073111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4822 NEWPORT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921073111",
            "telephone_number": "509-869-5926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGAN",
        "first_name": "JARED",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-07",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3419ATI",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14385TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luke Haffner
• Michael Amin Haft, MD
• Sandra Marie Haftorson
• Cami Michele Hagan, BA
• Dawn C Hagan, M.D.
• Michael John Hagan, LMFT #131272
• Mellissa Hagberg, LCSW
• Hage Dental Corporation
• Morgan Hage
• Brittany Anne Hagedorn

• Optometrist in San Diego, CA
• Providers in San Diego, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; 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.