DR. JENNIE JESSICA FAN OD
NPI 1801093570
Optometrist in Los Angeles, CA

Q: What is Jennie Fan's NPI number?

The NPI number for Jennie Fan is 1801093570. It was assigned to this individual provider in the NPPES registry on June 27, 2007.

Q: What is Jennie Fan's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jennie Fan was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.

Active since June 27, 2007PECOS Enrolled

1300 N VERMONT AVE, DOCTOR'S TOWER, SUITE 101, LOS ANGELES, CA 90027(323) 667-2102 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Dr. Jennie Jessica Fan Od NPPES

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

DR. JENNIE JESSICA FAN OD (NPI 1801093570) is an individual optometrist in Los Angeles, California, licensed in California (13246) and active in the NPI registry since June 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1801093570

Entity TypeIndividualFemale

Primary Taxonomy152W00000X

Provider Legal NameDR. JENNIE JESSICA FANCredential: OD

Location Address1300 N VERMONT AVE, DOCTOR'S TOWER, SUITE 101Los Angeles, CA 90027-6005

Mailing Address28281 SomersetMission Viejo, CA 92692-2889 · (949) 581-2239 · Fax (949) 472-8163

Phone(323) 667-2102

Sole ProprietorNo

Enumeration DateJune 27, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1801093570 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in CA · 13246

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.

1300 N VERMONT AVE, Los Angeles, CA 90027

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jennie Jessica Fan Od is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jennie Fan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Third Optometric Care Of California

24 mi

Optometrist

7960 ORANGETHORPE AVE
Buena Park, CA 90621

Reassigned Medicare billing, California enrollment
29 clinicians in this Medicare group

NPI 1891468849 (714) 521-3002

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90027 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$142.39 typical visit price

range $62.96 – $187.60

Typical copayment $35.59 (range $15.74 – $46.90)

Most-billed visit code 99204

Established Patient

$77.96 typical visit price

range $20.84 – $153.61

Typical copayment $19.49 (range $5.21 – $38.40)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANOOSHEH NIKKAR PA-C

Physician Assistant (Surgical)

1300 N VERMONT AVE, #1006
LOS ANGELES, CA 90027

Los Angeles County (323) 361-2169

DR. RALPH WATCHI MD

Pediatrics

1300 N VERMONT AVE, SUITE 901
LOS ANGELES, CA 90027

Los Angeles County (323) 912-9221

DR. RAM KUMAR SHARMA M.D.

Anesthesiology

1300 N VERMONT AVE
LOS ANGELES, CA 90027

Los Angeles County (213) 413-3000

DR. SUNG HWAN KIM M.D.

Anesthesiology

1300 N VERMONT AVE
LOS ANGELES, CA 90027

Los Angeles County (213) 413-3000

DR. CHRISTINA SOUTHER MARTIN MD

Surgery

1300 N VERMONT AVE, #704
LOS ANGELES, CA 90027

Los Angeles County (310) 526-0290

ERNEST JAMES RIN MD

Emergency Medicine

1300 N VERMONT AVE
LOS ANGELES, CA 90027

Los Angeles County (213) 413-3000

HOLLYWOOD EMERGENCY PHYSICIANS

Emergency Medicine

1300 N VERMONT AVE
LOS ANGELES, CA 90027

Los Angeles County (323) 913-4892

DR. DALLAS COTTAM M.D.

Emergency Medicine

1300 N VERMONT AVE, SUITE 403 DOCTORS TOWER
LOS ANGELES, CA 90027

Los Angeles County (323) 644-1300

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 Jennie Fan's NPI number?

The NPI number for Jennie Fan is 1801093570. It was assigned to this individual provider in the NPPES registry on June 27, 2007.

Where is Jennie Fan located?

Jennie Fan practices at 1300 N Vermont Ave Doctor's Tower, Suite 101, Los Angeles, CA 90027. The listed phone number is (323) 667-2102.

What is Jennie Fan's specialty?

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

Is Jennie Fan enrolled in Medicare?

Yes. Jennie Fan is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jennie Fan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jennie Fan reassigns Medicare benefits to Third Optometric Care Of California (Buena Park, CA). The 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 Jennie Fan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jennie Fan accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 2 other insurers list Jennie Fan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jennie Fan was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.