Active NPI
Nina Hue Van, OD
- Optometrist
- San Jose, CA
National Provider Identifier
1932835956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 10564
- Practice address
- 1183 S de Anza Blvd Ste 50
San Jose, CA 95129-3659 - Phone
- (408) 366-1681
- Fax
- (408) 366-1680
- NPI assigned
- Aug 1, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 10564 | TX | Primary |
Addresses
Primary practice location
1183 S de Anza Blvd Ste 50
San Jose, CA 95129-3659
Mailing address
250 Baldwin Ave Apt 308
San Mateo, CA 94401-3900
Phone (562) 912-9264
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35409TLG | Other | CA | LICENSE |
| 10564 | Other | TX | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10564 | TX | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| J Pietrantonio OD Inc | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Optometrist
- Los Gatos, CA
- NPI 1346442043
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700006400000",
"number": "1932835956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 BALDWIN AVE APT 308",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944013900",
"telephone_number": "562-912-9264"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1183 S DE ANZA BLVD STE 50",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951293659",
"telephone_number": "408-366-1681",
"fax_number": "408-366-1680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN",
"first_name": "NINA",
"middle_name": "HUE",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-01",
"last_updated": "2023-11-15",
"certification_date": "2023-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "10564",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "35409TLG",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "10564",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.