Individual provider Active NPI

Bita Shoku, OD

  • Optometrist
  • Los Angeles, CA
National Provider Identifier
1225050495
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT12043T Issued in CA
Practice address
100 Stein PLZ
Los Angeles, CA 90095-7065
Phone
(310) 825-3090
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT12043T CA Primary

Addresses

Primary practice location

100 Stein PLZ
Los Angeles, CA 90095-7065

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other identifiers 1

IdentifierTypeStateIssuer
SD0120430MedicaidCA

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
I20110204000847 CA Practitioner - Optometry 5698955813 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

622 W Duarte Rd
Suite 101
Arcadia, CA 91007-7606
Phone (323) 442-7122

Merit-based Incentive Payment System (MIPS)

Final score
86.31 of 100Reported as group
Quality
78.96
Promoting interoperability
100
Improvement activities
40
Cost
71.72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT12043TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Jules Stein Eye Institute Medical Group CurrentSince May 1, 2002 Accepting new patients
Optometrix Optometrist CurrentSince May 11, 2017 Accepting new patients
Jules Stein Eye Institute Medical Group CurrentSince May 1, 2002 Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
UCLA Medical Group Past Accepting new patients

Locations

622 W Duarte Rd
Ste 101
Arcadia, CA 91007
Phone (310) 206-1166

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

100 Stein Plz
Rm 1340
Los Angeles, CA 90095
Phone (310) 206-1166

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

11701 Wilshire Blvd
Ste 10
Los Angeles, CA 90025
Phone (310) 820-7866

100 Stein Plz
Los Angeles, CA 90095
Phone (310) 825-3090

Interoperability endpoints

  • Direct secure messaging: bshokouh48213@direct.uclahealth.org

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1225050495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 STEIN PLZ",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900957065",
            "telephone_number": "310-825-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOKU",
        "first_name": "BITA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT12043T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0120430",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.