Individual provider Active NPI

Suzanne D Huang, O.D.

  • Optometrist
  • Novato, CA
National Provider Identifier
1215936174
Registry record updated May 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8252T Issued in CA
Practice address
1300 Grant Ave
#102
Novato, CA 94945-3167
Phone
(415) 898-2320
Fax
(415) 892-7000
NPI assigned
Jul 21, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8252T CA Primary

Addresses

Primary practice location

1300 Grant Ave
#102
Novato, CA 94945-3167

Mailing address

1300 Grant Ave
#102
Novato, CA 94945-3167
Phone (415) 898-2320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8252TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Deval Patel Optometric Corporation Optometrist CurrentSince Mar 18, 2022 Accepting new patients

Locations

1300 Grant Ave
Ste 102
Novato, CA 94945
Phone (415) 898-2320

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": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241136000000",
    "number": "1215936174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 GRANT AVE",
            "address_2": "#102",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949453167",
            "telephone_number": "415-898-2320",
            "fax_number": "415-892-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 GRANT AVE",
            "address_2": "#102",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949453167",
            "telephone_number": "415-898-2320",
            "fax_number": "415-892-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUANG",
        "first_name": "SUZANNE",
        "middle_name": "D",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-21",
        "last_updated": "2009-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8252T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novato, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.