Individual provider Active NPI

Susan Pi-Shian Hsu, OD

  • Optometrist
  • Pacifica, CA
National Provider Identifier
1164403556
Registry record updated Jun 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8365TPA Issued in CA
Practice address
2014 Palmetto Ave
Ste B
Pacifica, CA 94044-2796
Phone
(650) 359-2231
Fax
(650) 359-2305
NPI assigned
Nov 11, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8365TPA CA Primary

Addresses

Primary practice location

2014 Palmetto Ave
Ste B
Pacifica, CA 94044-2796

Mailing address

2014 Palmetto Ave
Ste B
Pacifica, CA 94044-2796
Phone (650) 359-2231

Other identifiers 1

IdentifierTypeStateIssuer
BG279ZOtherCAMEDICARE PTAN

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
I20090127000678 CA Practitioner - Optometry 4385708833 Practice locations: Pacifica, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8365TPACAMDOptometrist
8365CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacifica Sun Optometry Inc Optometrist PastSince Sep 1, 2024 Accepting new patients

Organizations & group practices 1

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": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276041600000",
    "number": "1164403556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2014 PALMETTO AVE",
            "address_2": "STE B",
            "city": "PACIFICA",
            "state": "CA",
            "postal_code": "940442796",
            "telephone_number": "650-359-2231",
            "fax_number": "650-359-2305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 PALMETTO AVE",
            "address_2": "STE B",
            "city": "PACIFICA",
            "state": "CA",
            "postal_code": "940442796",
            "telephone_number": "650-359-2231",
            "fax_number": "650-359-2305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HSU",
        "first_name": "SUSAN",
        "middle_name": "PI-SHIAN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-11",
        "last_updated": "2010-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8365TPA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "BG279Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacifica, CA

Sources for this page

Verify at the official NPI Registry.