Individual provider Active NPI

Janis Valorie Gong, O.D.

  • Optometrist
  • Los Gatos, CA
National Provider Identifier
1962477109
Registry record updated Apr 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5609T Issued in CA
Practice address
825 Pollard Rd
Suite 208
Los Gatos, CA 95032-1435
Phone
(408) 378-1701
NPI assigned
Feb 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5609T CA Primary

Addresses

Primary practice location

825 Pollard Rd
Suite 208
Los Gatos, CA 95032-1435

Mailing address

825 Pollard Rd
Suite 208
Los Gatos, CA 95032-1435
Phone (408) 378-1701

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
I20120124000211 CA Practitioner - Optometry 5193992618 Reassigns benefits to 1 organization
Practice locations: Los Gatos, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5609TCAMDOptometrist

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.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208476800000",
    "number": "1962477109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 POLLARD RD",
            "address_2": "SUITE 208",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321435",
            "telephone_number": "408-378-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 POLLARD RD",
            "address_2": "SUITE 208",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321435",
            "telephone_number": "408-378-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONG",
        "first_name": "JANIS",
        "middle_name": "VALORIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2008-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5609T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

Verify at the official NPI Registry.