Derrick Guy Lim, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

10509TPL Issued in CA

Practice address

5649 Atlantic Ave
Long Beach, CA 90805-4710

Phone

(562) 422-3378

NPI assigned

Nov 4, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: derrick.limod.p1@direct.jwch.nextgenshare.com

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.

• Northeast Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Hawthorne, CA
  • NPI 1275226334
  NPD
• Northeast Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1891200325
  NPD
• Universal Care

  • Pediatrics Physician
  • Long Beach, CA
  • NPI 1376632877
  NPD (past)

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1073504262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5649 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908054710",
            "telephone_number": "562-422-3378",
            "fax_number": "909-869-9354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5649 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908054710",
            "telephone_number": "562-422-3378"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4455 W 117th St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Hawthorne",
            "state": "CA",
            "postal_code": "902502240",
            "country_code": "US",
            "telephone_number": "310-219-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIM",
        "first_name": "DERRICK",
        "middle_name": "GUY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10509TPL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0105090",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Ligorria
• Lilia Sheynman, PHD Inc.,
• Susan Lillicrop, RPH
• Bridgett Larhonda Lilly, LVN
• Aaron Lim
• Judy Lim, NP
• Maria W Lim, OTR,L
• Minho Lim, LVN
• Phalen Sok Lim
• Polen Lim, O.D.

• Optometrist in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.