Derek Pi, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

35155 Issued in CA

Practice address

4200 Chino Hills Pkwy
Chino Hills, CA 91709-3776

Phone

(909) 393-9058

NPI assigned

Apr 12, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Southern California College of Optometry, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chino Hills Optometry IncGroup PAC ID 9830448745, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Chino Hills Optometry Inc

  • Optometrist
  • Chino Hills, CA
  • NPI 1144488032
  Medicare reassignment Care Compare group NPD
• Corona Valley Optometry Inc

  • Optometrist
  • Corona, CA
  • NPI 1295993103
  Medicare reassignment NPD

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

{
    "created_epoch": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1215517396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20612 SHEPHERD HILLS DR",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917895402",
            "telephone_number": "909-358-7491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 CHINO HILLS PKWY",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917093776",
            "telephone_number": "909-393-9058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PI",
        "first_name": "DEREK",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-12",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jimmy Bao Pham, DDS
• Tiffany Pham, OD
• Uyen Phuong Pham, DDS
• Sara Lauren Phung, DDS
• Phyllis K. Kawada, DDS, Ms, a Professional Corporation
• Jimmy Pineda
• Ping-Lin Ben Chung, DDS, DMSC, Inc
• Marian Pishay, OD
• Mark Pishay
• Clifford James Pittman

• Optometrist in Chino Hills, CA
• Providers in Chino Hills, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.