Individual provider Active NPI

Teresa T Wu, O.D.

  • Optometrist
  • Los Gatos, CA
National Provider Identifier
1194764340
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11540 Issued in CA
Practice address
14777 Los Gatos Blvd Ste 201
Los Gatos, CA 95032-2059
Phone
(408) 243-2020
Fax
(408) 243-2021
NPI assigned
Jun 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11540 CA Primary

Addresses

Primary practice location

14777 Los Gatos Blvd Ste 201
Los Gatos, CA 95032-2059

Mailing address

14777 Los Gatos Blvd Ste 201
Los Gatos, CA 95032-2059
Phone (408) 243-2020

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
I20150831001081 CA Practitioner - Optometry 1052627411 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
De Anza Vision Center a Professional Optometric Corp Optometrist PastSince Dec 1, 2021 Accepting new patients

Organizations & group practices 2

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1194764340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14777 LOS GATOS BLVD STE 201",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322059",
            "telephone_number": "408-243-2020",
            "fax_number": "408-243-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14777 LOS GATOS BLVD STE 201",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322059",
            "telephone_number": "408-243-2020",
            "fax_number": "408-243-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "TERESA",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

Verify at the official NPI Registry.