Dr. Jeffrey T. Kubo Optometry, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

DR. JEFFREY T. KUBO OPTOMETRY, INC.

Practice address

223 E Thousand Oaks Blvd Ste 417
Thousand Oaks, CA 91360-5840

Phone

(805) 379-9912

NPI assigned

Jul 12, 2021

Last updated

Jul 12, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeffrey Kubo, ODNPI 1215071824

Title

Owner

Phone

(805) 379-9912

Specialties & licenses 1

Addresses

Other names 1

• Jeffrey T Kubo OD Former legal business name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffrey T Kubo, O.D.

  • Optometrist
  • Thousand Oaks, CA
  • NPI 1215071824
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626048000000",
    "number": "1912579780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3202 PROVENCE PL",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913624844",
            "telephone_number": "805-379-9912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 E THOUSAND OAKS BLVD STE 417",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913605840",
            "telephone_number": "805-379-9912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JEFFREY T. KUBO OPTOMETRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-12",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A",
        "authorized_official_last_name": "KUBO",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-379-9912",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jeffrey T Kubo OD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Optometrist in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.