NPIMap

Organization Active NPI

Vision Dynamics Optometric Center

  • Optometrist
  • Danville, CA
National Provider Identifier
1023378635
Registry record updated May 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
007869 Issued in CA
Legal business name
VISION DYNAMICS OPTOMETRIC CENTER
Doing business as
Vision Dynamics Optometry
Practice address
417 Sycamore Valley Road West
Danville, CA 94526
Phone
(925) 838-3021
Fax
(925) 838-9068
NPI assigned
May 17, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2012

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

Authorized official

Name
Dr. Amy S Lin, O.D.NPI 1407925811
Title
Owner/President/Doctor
Phone
(925) 838-3021

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 007869 CA Primary

Addresses

Primary practice location

417 Sycamore Valley Road West
Danville, CA 94526

Mailing address

1480 Moraga Rd
Suite I - 222
Moraga, CA 94556-2005
Phone (415) 786-4521

Other names 1

  • Vision Dynamics Optometry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121002000511 CA Part B Supplier - Clinic/Group Practice 9234388562 Receives reassigned benefits from 7 practitioners
Practice locations: Danville, CA

National Provider Directory

National Provider Directory

Locations

417 Sycamore Valley Rd W
Danville, CA 94526
Phone (925) 838-3021

1480 Moraga Rd
Ste I
Moraga, CA 94556
Phone (415) 786-4521

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1337212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337212800000",
    "number": "1023378635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 MORAGA RD",
            "address_2": "SUITE I - 222",
            "city": "MORAGA",
            "state": "CA",
            "postal_code": "945562005",
            "telephone_number": "415-786-4521",
            "fax_number": "206-426-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 SYCAMORE VALLEY ROAD WEST",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "94526",
            "telephone_number": "925-838-3021",
            "fax_number": "925-838-9068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION DYNAMICS OPTOMETRIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-17",
        "last_updated": "2012-05-17",
        "status": "A",
        "authorized_official_last_name": "LIN",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/PRESIDENT/DOCTOR",
        "authorized_official_telephone_number": "925-838-3021",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "007869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Dynamics Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Danville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.