Individual provider Active NPI

Annie Tsuen Chin, O.D.

  • Optometrist
  • San Diego, CA
National Provider Identifier
1124191556
Registry record updated Jun 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13070T Issued in CA
Practice address
3075 Health Center Dr
San Diego, CA 92123-2773
Phone
(858) 939-5400
Fax
(858) 939-5419
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13070T CA Primary
Corneal and Contact Management Optometrist 152WC0802X 13070T CA

Addresses

Primary practice location

3075 Health Center Dr
San Diego, CA 92123-2773

Mailing address

3075 Health Center Dr
San Diego, CA 92123-2773
Phone (858) 939-5400

Other identifiers 1

IdentifierTypeStateIssuer
SD0130700MedicaidCA

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
I20071013000079 CA Practitioner - Optometry 2466548938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

3075 Health Ctr Dr
Suite 401
San Diego, CA 92123-2773
Phone (858) 499-2600

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13070TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc Optometrist CurrentSince Jun 4, 2012 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Optometrist CurrentSince Jun 4, 2012 Accepting new patients
Mark a Fujikawa & Stephen R Chun PTR Optometrist PastSince May 28, 2015 Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients

Locations

7862 El Cajon Blvd
La Mesa, CA 91942
Phone (619) 644-6401

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

3075 Health Center Dr
Ste 401
San Diego, CA 92123
Phone (858) 939-5400

Interoperability endpoints

  • Direct secure messaging: achin34166@sharphealthcare.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1124191556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 HEALTH CENTER DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232773",
            "telephone_number": "858-939-5400",
            "fax_number": "858-939-5419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3075 HEALTH CENTER DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232773",
            "telephone_number": "858-939-5400",
            "fax_number": "858-939-5419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIN",
        "first_name": "ANNIE",
        "middle_name": "TSUEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13070T",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "13070T",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0130700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.