Active NPI
Betty Wai-Han Lee-Villanueva, O.D.
- Optometrist
- Glendale, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 11366T
- Practice address
- 330 N Brand Blvd
Suite 110
Glendale, CA 91203-2308 - Phone
- (866) 260-2020
- NPI assigned
- Jun 22, 2006
- Last updated
- Dec 16, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 11366T | CA | Primary |
Addresses
Primary practice location
330 N Brand Blvd
Suite 110
Glendale, CA 91203-2308
Mailing address
330 N Brand Blvd
Suite 110
Glendale, CA 91203-2308
Phone (866) 260-2020
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 041522 | Other | CA | COLE PROVIDER NUMBER |
| 1306035118 | Medicaid | CA | |
| 9362933 | Other | CA | MEDICAL |
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 CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11366T | CA | MD | Optometrist |
| 11366 | CA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Eyecare Professional Optometric Group | Optometrist | Current | Accepting new patients |
| Greta Torossian, Optometric Corp. | Optometrist | Current | Accepting new patients |
| Physicians Network Services Medical Group | Optometrist | Past | Accepting new patients |
| Pearle Visioncare, Inc | Past | Accepting new patients | |
| Craig Anthony Lenz | Past | Accepting new patients |
Locations
7509 Laurel Ave
Fontana, CA 92336
Phone (805) 485-3338
330 N Brand Blvd
Ste 110
Glendale, CA 91203
Phone (818) 240-0890
1055 Foothill Blvd
La Canada, CA 91011
1057 Foothill Blvd
La Canada Flintridge, CA 91011
Phone (818) 550-0411
6702 Inglewood Ave
Ste H
Stockton, CA 95207
Phone (209) 951-3937
Organizations & group practices 5
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.
-
- Optometrist
- Glendale, CA
- NPI 1821152273
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- Optometrist
- Glendale, CA
- NPI 1306035118
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- Optometrist
- Placentia, CA
- NPI 1457445215
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292457600000",
"number": "1073559233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 N BRAND BLVD",
"address_2": "SUITE 110",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912032308",
"telephone_number": "866-260-2020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 N BRAND BLVD",
"address_2": "SUITE 110",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912032308",
"telephone_number": "866-260-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE-VILLANUEVA",
"first_name": "BETTY",
"middle_name": "WAI-HAN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-22",
"last_updated": "2010-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "11366T",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COLE PROVIDER NUMBER",
"identifier": "041522",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1306035118",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL",
"identifier": "9362933",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2010; 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.