Individual provider Active NPI

Jasmine Su

  • Optometrist
  • Monterey Park, CA
National Provider Identifier
1063199438
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
35522 Issued in CA
Practice address
537 S Atlantic Blvd
Monterey Park, CA 91754-3815
Phone
(323) 264-2015
NPI assigned
Jun 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 35522 CA Primary

Addresses

Primary practice location

537 S Atlantic Blvd
Monterey Park, CA 91754-3815

Mailing address

5117 Bartlett Ave
San Gabriel, CA 91776-2125
Phone (626) 823-8588

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
I20240116003352 CA Practitioner - Optometry 2769846104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dennis Lin, O.D., IncGroup PAC ID 6002994993, 2 clinicians

Practice addresses (Care Compare)

537 S Atlantic Blvd
Monterey Park, CA 91754-3815
Phone (323) 264-2015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dennis Lin, O.D., Inc Optometrist CurrentSince Dec 1, 2023 Accepting new patients

Locations

537 S Atlantic Blvd
Monterey Park, CA 91754
Phone (323) 264-2015

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1063199438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5117 BARTLETT AVE",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917762125",
            "telephone_number": "626-823-8588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 S ATLANTIC BLVD",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917543815",
            "telephone_number": "323-264-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SU",
        "first_name": "JASMINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey Park, CA

Sources for this page

Verify at the official NPI Registry.