Individual provider Active NPI

Dickson Chen, O.D.

  • Optometrist
  • Los Angeles, CA
National Provider Identifier
1225009723
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10046T Issued in CA
Practice address
219 S Vermont Ave
Los Angeles, CA 90004-5906
Phone
(626) 817-2817
NPI assigned
Feb 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10046T CA Primary

Addresses

Primary practice location

219 S Vermont Ave
Los Angeles, CA 90004-5906

Mailing address

219 S Vermont Ave
Los Angeles, CA 90004-5906
Phone (626) 817-2817

Other identifiers 1

IdentifierTypeStateIssuer
SD00100460MedicaidCA

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
I20110916000282 CA Practitioner - Optometry 7012188303 Practice locations: Los Angeles, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

219 S Vermont Ave
Los Angeles, CA 90004-5906
Phone (626) 817-2817

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
94.25
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10046TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eb Professional Services Optometry PC Optometrist PastSince Jun 12, 2022 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": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1225009723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900045906",
            "telephone_number": "626-817-2817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900045906",
            "telephone_number": "626-817-2817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "DICKSON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2022-06-06",
        "certification_date": "2022-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10046T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD00100460",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.