Individual provider Active NPI

Melissa Li, OD

  • Optometrist
  • Pleasanton, CA
National Provider Identifier
1063082972
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34939 Issued in CA
Practice address
1104 Stoneridge Mall Rd
Pleasanton, CA 94588-3219
Phone
(925) 463-3520
NPI assigned
Jul 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34939 CA Primary

Addresses

Primary practice location

1104 Stoneridge Mall Rd
Pleasanton, CA 94588-3219

Mailing address

457 38TH St
Oakland, CA 94609-2732
Phone (510) 960-0437

Other practice location 1

2580 Old 1st St
Livermore, CA 94550-2055
Phone (925) 449-8188

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211008002225 CA Practitioner - Optometry 2567860398 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Accuvision Eyecare OptometryGroup PAC ID 4082833702, 3 clinicians
Foresight Eyecare OptometryGroup PAC ID 5092093435, 2 clinicians

Practice addresses (Care Compare)

2580 Old 1St St
Livermore, CA 94550-2055
Phone (925) 449-8188

5442 Ygnacio Valley Rd
Suite 180
Concord, CA 94521-3828
Phone (925) 672-4100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Accuvision Eyecare Optometry Optometrist CurrentSince Jun 8, 2022 Accepting new patients
Foresight Optometry Incorporated Optometrist CurrentSince Jan 10, 2023 Accepting new patients

Locations

5442 Ygnacio Valley Rd
Ste 180
Concord, CA 94521
Phone (925) 672-4100

2580 Old 1st St
Livermore, CA 94550
Phone (925) 449-8188

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1063082972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 38TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946092732",
            "telephone_number": "510-960-0437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 STONERIDGE MALL RD",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945883219",
            "telephone_number": "925-463-3520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2580 Old 1st St",
            "address_purpose": "LOCATION",
            "city": "Livermore",
            "state": "CA",
            "postal_code": "945502055",
            "country_code": "US",
            "telephone_number": "925-449-8188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LI",
        "first_name": "MELISSA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-01",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.