Individual provider Active NPI

Yangzi Maggie Jiang, O.D.

  • Optometrist
  • West Jordan, UT
National Provider Identifier
1932249901
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
UVT007131 Issued in NY
Practice address
7571 S 3800 W
West Jordan, UT 84084-4319
Phone
(801) 282-5682
Fax
(801) 282-5684
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X UVT007131 NY Primary

Addresses

Primary practice location

7571 S 3800 W
West Jordan, UT 84084-4319

Mailing address

1918 E Rich Way
Salt Lake City, UT 84121-4881
Phone (801) 505-9886

Other practice location 1

4270 Kissena Blvd
Flushing, NY 11355-3213
Phone (718) 888-9838

Other identifiers 2

IdentifierTypeStateIssuer
1932249901MedicaidUT
U000086030OtherUTMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20140326001525 UT Practitioner - Optometry 6901978055 Practice locations: West Jordan, UT

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7571 S 3800
West Jordan, UT 84084-4319
Phone (801) 282-5682

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
UVT007131NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Fashion Optical, Inc Optometrist PastSince Nov 17, 2019 Accepting new patients
Advanced Eye Physician PLLC Optometrist PastSince Jan 1, 2005 Accepting new patients

Organizations & group practices 2

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": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1932249901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1918 E RICH WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841214881",
            "telephone_number": "801-505-9886",
            "fax_number": "801-282-5684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7571 S 3800 W",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840844319",
            "telephone_number": "801-282-5682",
            "fax_number": "801-282-5684"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4270 Kissena Blvd",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113553213",
            "country_code": "US",
            "telephone_number": "718-888-9838",
            "fax_number": "212-227-4651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIANG",
        "first_name": "YANGZI",
        "middle_name": "MAGGIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "UVT007131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932249901",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "U000086030",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jordan, UT

Sources for this page

Verify at the official NPI Registry.