JIMMY K. SO, OD, INC.
NPI 1154746345
Optometrist in Upland, CA

Q: What is Jimmy K. So, Od, Inc.'s NPI number?

The NPI number for Jimmy K. So, Od, Inc. is 1154746345. It was assigned to this organization in the NPPES registry on February 24, 2014.

Q: What is Jimmy K. So, Od, Inc.'s specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Active since February 24, 2014

1261 W FOOTHILL BLVD STE B, UPLAND, CA 91786(909) 982-9366(909) 982-2477 Get Directions Write a Review

NPPES record last updated: February 24, 2014. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Jimmy K. So, Od, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JIMMY K. SO, OD, INC. (NPI 1154746345) is a healthcare organization registered as an optometrist in Upland, California and active in the NPI registry since February 2014. The organization lists Jimmy K. So, President, as its authorized official.

NPPES Registry Identity

NPI1154746345

Entity TypeOrganization

Primary Taxonomy152W00000X

Legal Business NameJIMMY K. SO, OD, INC.

Location Address1261 W FOOTHILL BLVD STE BUpland, CA 91786-8019

Mailing Address1261 W Foothill Blvd Ste BUpland, CA 91786-8019 · (909) 982-9366 · Fax (909) 982-2477

Phone(909) 982-9366

Fax(909) 982-2477

Organization SubpartNo

Authorized OfficialJimmy K. SoPresident · (909) 982-9366

Enumeration DateFebruary 24, 2014

✔ NPI 1154746345 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in CA · 10554T

Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Also ListedOptometrist · Corneal and Contact ManagementTaxonomy 152WC0802X · License 10554T (CA)

1261 W FOOTHILL BLVD STE B, Upland, CA 91786

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jimmy K. So, Od, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Jimmy K. So, Od, Inc., which bills Medicare for the services this clinician delivers.

Clinician (1)

Jimmy So, OD

Optometry

NPI 1548233059

1261 W FOOTHILL BLVD STE B
Upland, CA 91786

(909) 982-9366

✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jimmy K. So, Od, Inc.'s NPI number?

The NPI number for Jimmy K. So, Od, Inc. is 1154746345. It was assigned to this organization in the NPPES registry on February 24, 2014.

Where is Jimmy K. So, Od, Inc. located?

Jimmy K. So, Od, Inc. is located at 1261 W Foothill Blvd Ste B, Upland, CA 91786. The listed phone number is (909) 982-9366.

What is Jimmy K. So, Od, Inc.'s specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Jimmy K. So, Od, Inc. enrolled in Medicare?

Yes. Jimmy K. So, Od, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jimmy K. So, Od, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Jimmy K. So, Od, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Jimmy K. So, Od, Inc. was last updated on February 24, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.