Individual provider Active NPI

Shan Ma, OD

  • Optometrist
  • San Diego, CA
National Provider Identifier
1174175129
Registry record updated Feb 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT35938-TLG Issued in CA
Practice address
8230 Mira Mesa Blvd Ste B
San Diego, CA 92126-2625
Phone
(858) 566-6670
NPI assigned
Jul 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT35938-TLG CA Primary

Addresses

Primary practice location

8230 Mira Mesa Blvd Ste B
San Diego, CA 92126-2625

Mailing address

8230 Mira Mesa Blvd Ste B
San Diego, CA 92126-2625
Phone (858) 566-6670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200402001672 MA Practitioner - Optometry 0446689046 Reassigns benefits to 2 organizations
I20250811003946 CA Practitioner - Optometry 0446689046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Vision PCGroup PAC ID 9234472242, 115 clinicians

Practice addresses (Care Compare)

8230 Mira Mesa Blvd
Suite B
San Diego, CA 92126-2625
Phone (858) 566-6670

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5358MAMDMental Health Counselor
OPT35938-TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Natick Eye Associates, PC Optometrist CurrentSince Jan 26, 2020 Accepting new patients
Aeg Massachusetts Professional PC Optometrist CurrentSince Aug 30, 2024 Accepting new patients
Total Vision PC Optometrist CurrentSince Jul 29, 2025 Accepting new patients
Mira Mesa Optometry, Inc Optometrist CurrentSince Jul 29, 2025 Accepting new patients
Steven T Klein OD & Kimberly Plattner OD a Professional Corporation Optometrist Past Accepting new patients

Locations

27271 Las Ramblas
Ste 210
Mission Viejo, CA 92691

11717 Bernardo Plaza Ct
Ste 105
San Diego, CA 92128
Phone (858) 487-5555

8230 Mira Mesa Blvd
Ste B
San Diego, CA 92126
Phone (858) 566-6670

15 Central St
Andover, MA 01810
Phone (978) 475-1230

77 W Main St
Ste 210
Hopkinton, MA 01748
Phone (508) 435-5455

77 W Main St
Hopkinton, MA 01748
Phone (508) 435-5506

1364 Worcester St
Natick, MA 01760
Phone (508) 653-2102

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": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1174175129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8230 MIRA MESA BLVD STE B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921262625",
            "telephone_number": "858-566-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8230 MIRA MESA BLVD STE B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921262625",
            "telephone_number": "858-566-6670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MA",
        "first_name": "SHAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-10",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT35938-TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.