Individual provider Active NPI

Tanya Ngo

  • Optometrist
  • Yorba Linda, CA
National Provider Identifier
1073278826
Registry record updated Nov 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
35064 Issued in CA
Practice address
18291 Imperial Hwy
Yorba Linda, CA 92886-3408
Phone
(714) 777-1770
NPI assigned
Nov 6, 2021
Last updated
Nov 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 35064 CA Primary

Addresses

Primary practice location

18291 Imperial Hwy
Yorba Linda, CA 92886-3408

Mailing address

16617 Harroway Ave
Cerritos, CA 90703-1462
Phone (562) 405-7187

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
I20220114000906 CA Practitioner - Optometry 4688066061 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
International American University at Puerto Rico - School of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
17TH Street Optometry ApcGroup PAC ID 5395087100, 2 clinicians
Old Towne Optometry IncGroup PAC ID 5496003329, 2 clinicians

Practice addresses (Care Compare)

17300 17TH St
Suite M
Tustin, CA 92780-1955
Phone (714) 838-9664

18291 Imperial Hwy
Yorba Linda, CA 92886-3408
Phone (714) 777-1770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35064CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Old Towne Optometry, Inc. Optometrist CurrentSince Nov 2, 2021 Accepting new patients
Marsha Howard Optometric Corp Optometrist CurrentSince Jul 1, 2022 Accepting new patients
17TH Street Optometry Apc Optometrist CurrentSince Aug 1, 2024 Accepting new patients
Kimberly Shih O.D., Inc Optometrist PastSince Nov 2, 2021 Accepting new patients

Locations

2200 E Willow St
Signal Hill, CA 90755
Phone (562) 424-2837

17300 17th St
Ste M
Tustin, CA 92780
Phone (714) 838-9664

18291 Imperial Hwy
Yorba Linda, CA 92886
Phone (714) 777-1770

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1636156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636156800000",
    "number": "1073278826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16617 HARROWAY AVE",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907031462",
            "telephone_number": "562-405-7187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18291 IMPERIAL HWY",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928863408",
            "telephone_number": "714-777-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGO",
        "first_name": "TANYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-06",
        "last_updated": "2021-11-06",
        "certification_date": "2021-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorba Linda, CA

Sources for this page

Verify at the official NPI Registry.