Kelly Lao, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

10646T Issued in CA

Practice address

240 Meridian Ave Ste 1
San Jose, CA 95126-2927

Phone

(408) 293-7576

Fax

(408) 293-7579

NPI assigned

Sep 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Southern California College of Optometry, 1995

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Kelly Lao OD Apc

  • Optometrist
  • San Jose, CA
  • NPI 1215955141
  Medicare reassignment

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190073600000",
    "number": "1043406697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 MERIDIAN AVE STE 1",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951262927",
            "telephone_number": "408-293-7576",
            "fax_number": "408-293-7579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MERIDIAN AVE STE 1",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951262927",
            "telephone_number": "408-293-7576",
            "fax_number": "408-293-7579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAO",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2007-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10646T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in San Jose, CA
• Providers in San Jose, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.