Active NPI
Phoebe Nhi Luong, OD
- Optometrist
- Phoenix, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 002539
- Practice address
- 9515 W Camelback Rd Ste 110
Phoenix, AZ 85037-1365 - Phone
- (623) 937-1655
- NPI assigned
- Feb 8, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 34833 | CA | |
| Optometrist | 152W00000X | 002539 | AZ | Primary |
Addresses
Primary practice location
9515 W Camelback Rd Ste 110
Phoenix, AZ 85037-1365
Mailing address
20 Tidewater CV
Buena Park, CA 90621-1661
Phone (626) 213-7659
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3955 Bonita Rd
Bonita, CA 91902-1230
Phone (619) 528-5000
4647 Zion Ave
San Diego, CA 92120-2507
Phone (619) 528-5000
6911 Convoy CT
San Diego, CA 92111-1014
Phone (858) 573-1504
780 Shadowridge Dr
Vista, CA 92083-7986
Phone (619) 528-5000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002539 | AZ | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| The Vision Center of West Phoenix | Optometrist | Past | Accepting new patients |
Locations
393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914
4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038
Organizations & group practices 4
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.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Health Maintenance Organization
- Los Angeles, CA
- NPI 1043242563
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Optometrist
- Phoenix, AZ
- NPI 1831401934
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695686400000",
"number": "1043964232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 TIDEWATER CV",
"city": "BUENA PARK",
"state": "CA",
"postal_code": "906211661",
"telephone_number": "626-213-7659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9515 W CAMELBACK RD STE 110",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850371365",
"telephone_number": "623-937-1655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUONG",
"first_name": "PHOEBE",
"middle_name": "NHI",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-08",
"last_updated": "2023-09-26",
"certification_date": "2022-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "34833",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AZ",
"license": "002539",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "4647 Zion Ave",
"city": "San Diego",
"state": "CA",
"country_code": "US",
"postal_code": "921202507",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; 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.