Individual provider Active NPI

Yosra Mojaddidy Nasiri, O.D.

  • Optometrist
  • Fremont, CA
National Provider Identifier
1891192258
Registry record updated Jan 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
15163 Issued in CA
Practice address
39500 Liberty St
Fremont, CA 94538-2211
Phone
(510) 770-8040
NPI assigned
Dec 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 15163 CA Primary

Addresses

Primary practice location

39500 Liberty St
Fremont, CA 94538-2211

Mailing address

39500 Liberty St
Fremont, CA 94538-2211
Phone (510) 770-8040

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
I20180309002203 CA Order and Referring Only - OptometryPractitioner - Optometry 9931460896

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1417392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1891192258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39500 LIBERTY ST",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382211",
            "telephone_number": "510-770-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39500 LIBERTY ST",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382211",
            "telephone_number": "510-770-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASIRI",
        "first_name": "YOSRA",
        "middle_name": "MOJADDIDY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-01",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "15163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.