NPIMap

Organization Active NPI

Wyse Willa Optometry, Inc.

  • Optometrist
  • Los Angeles, CA
National Provider Identifier
1114613098
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
WYSE WILLA OPTOMETRY, INC.
Practice address
1609 N Vermont Ave
Los Angeles, CA 90027-5312
Phone
(323) 663-8346
Fax
(323) 663-2316
NPI assigned
Apr 13, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Authorized official

Name
Dr. Wendy Yvette May Shem, ODNPI 1821050162
Title
Optometrist/Ceo
Phone
(626) 796-3105

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1609 N Vermont Ave
Los Angeles, CA 90027-5312

Mailing address

1609 N Vermont Ave
Los Angeles, CA 90027-5312
Phone (323) 663-8346

Other names 1

  • Hollywood Vermont Optometrics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231018000249 CA Part B Supplier - Clinic/Group Practice 3072968577 Receives reassigned benefits from 5 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Los Angeles, CA; Pasadena, CA; Arcadia, CA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Wyse Willa Optometry Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1681344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681344000000",
    "number": "1114613098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 N VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275312",
            "telephone_number": "323-663-8346",
            "fax_number": "323-663-2316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 N VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275312",
            "telephone_number": "323-663-8346",
            "fax_number": "323-663-2316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYSE WILLA OPTOMETRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-13",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A",
        "authorized_official_last_name": "SHEM",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "YVETTE MAY",
        "authorized_official_title_or_position": "OPTOMETRIST/CEO",
        "authorized_official_telephone_number": "626-796-3105",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hollywood Vermont Optometrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.