Individual provider Active NPI

Jonathan Mak, OD

  • Optometrist
  • Ventura, CA
National Provider Identifier
1891219846
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
33779TLG Issued in CA
Practice address
801 S Victoria Ave Ste 206
Ventura, CA 93003-0401
Phone
(805) 650-2020
NPI assigned
Aug 1, 2017
Last updated
Apr 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 33779TLG CA Primary

Addresses

Primary practice location

801 S Victoria Ave Ste 206
Ventura, CA 93003-0401

Mailing address

801 S Victoria Ave Ste 206
Ventura, CA 93003-0401
Phone (805) 650-2020

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
I20170906003325 CA Practitioner - Optometry 5294008678 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Vision PCGroup PAC ID 9234472242, 115 clinicians

Practice addresses (Care Compare)

12461 W Washington Blvd
Los Angeles, CA 90066-5511
Phone (310) 390-6287

2380 Las Posas Rd
Suite C
Camarillo, CA 93010-3456
Phone (805) 987-2400

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33779TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
California Eye Medical Center Inc Single Specialty CurrentSince Aug 1, 2017 Accepting new patients
Total Vision PC Optometrist CurrentSince Jul 26, 2023 Accepting new patients
Marina Eyecare Center Optometrist Past Accepting new patients
Granada Hills Optometry Center Optometrist PastSince Mar 18, 2019 Accepting new patients
Mark a. Chung, O.D., a Professional Corporation Optometrist Past Accepting new patients
Martin S Schneider Optometrist Past Accepting new patients
Steven T Klein OD & Kimberly Plattner OD a Professional Corporation Optometrist Past Accepting new patients
Sacks Optical Boutique, LLC PastSince Aug 1, 2017 Accepting new patients

Locations

2380 Las Posas Rd
Ste C
Camarillo, CA 93010
Phone (805) 987-2400

1125 S Beverly Dr
Ste 710
Los Angeles, CA 90035
Phone (310) 275-1676

12461 W Washington Blvd
Los Angeles, CA 90066
Phone (310) 390-6287

955 Carrillo Dr
Ste 105
Los Angeles, CA 90048
Phone (323) 332-9871

27271 Las Ramblas
Ste 210
Mission Viejo, CA 92691

11717 Bernardo Plaza Ct
Ste 105
San Diego, CA 92128
Phone (858) 487-5555

8205 Santa Monica Blvd
West Hollywood, CA 90046
Phone (323) 650-0337

8205 Santa Monica Blvd
Ste 15
West Hollywood, CA 90046
Phone (323) 650-0337

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1891219846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S VICTORIA AVE STE 206",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930030401",
            "telephone_number": "805-650-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S VICTORIA AVE STE 206",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930030401",
            "telephone_number": "805-650-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAK",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-01",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33779TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.