Individual provider Active NPI

Connie Choi, O.D.

  • Optometrist
  • Union City, CA
National Provider Identifier
1104977693
Registry record updated Dec 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12903T Issued in CA
Practice address
30600 Dyer St
Union City, CA 94587-1717
Phone
(510) 441-7403
NPI assigned
Jan 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12903T CA Primary

Addresses

Primary practice location

30600 Dyer St
Union City, CA 94587-1717

Mailing address

308 Victoria Bay
Alameda, CA 94502-6522
Phone (510) 589-9758

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
I20230324002275 CA Order and Referring Only - OptometryPractitioner - Optometry 7618990086

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Clinica de la Raza IncGroup PAC ID 1557258282, shared by 11 NPIs, 130 clinicians

Practice addresses (Care Compare)

1030 International Blvd
Oakland, CA 94606-3730
Phone (510) 238-5400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Connie Choi Family Optometry Current Accepting new patients
Luxottica of America Inc. Past Accepting new patients
Luxottica of America Inc Past Accepting new patients

Locations

30600 Dyer St
Union City, CA 94587
Phone (510) 441-7403

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": "1168646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481068800000",
    "number": "1104977693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 VICTORIA BAY",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945026522",
            "telephone_number": "510-589-9758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30600 DYER ST",
            "city": "UNION CITY",
            "state": "CA",
            "postal_code": "945871717",
            "telephone_number": "510-441-7403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "CONNIE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-13",
        "last_updated": "2016-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12903T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, CA

Sources for this page

Verify at the official NPI Registry.