Individual provider Active NPI

Lyly Ung, O.D.

  • Low Vision Rehabilitation Optometrist
  • San Francisco, CA
National Provider Identifier
1235198631
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Low Vision Rehabilitation OptometristTaxonomy code 152WL0500X
License
10244TPL Issued in CA
Practice address
940 Geneva Ave
San Francisco, CA 94112-3403
Phone
(415) 585-6588
Fax
(415) 585-6403
NPI assigned
Mar 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Low Vision Rehabilitation Optometrist 152WL0500X 10244TPL CA Primary

Addresses

Primary practice location

940 Geneva Ave
San Francisco, CA 94112-3403

Mailing address

940 Geneva Ave
San Francisco, CA 94112-3403
Phone (415) 585-6588

Other identifiers 1

IdentifierTypeStateIssuer
SD0102441MedicaidCA

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
I20120522000907 CA Practitioner - Optometry 1557524907 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geneva Eye Care Optometry IncGroup PAC ID 6002044872, 2 clinicians

Practice addresses (Care Compare)

940 Geneva Ave
San Francisco, CA 94112-3403
Phone (415) 585-6588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10244TPLCAMDLow Vision Rehabilitation Optometrist
10244CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geneva Eye Care Optometry Inc CurrentSince Jul 1, 2013 Accepting new patients
Geneva Eye Care CurrentSince Oct 1, 1998 Accepting new patients

Locations

940 Geneva Ave
San Francisco, CA 94112
Phone (415) 585-6555

Organizations & group practices 3

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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1235198631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 GENEVA AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941123403",
            "telephone_number": "415-585-6588",
            "fax_number": "415-585-6403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 GENEVA AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941123403",
            "telephone_number": "415-585-6588",
            "fax_number": "415-585-6403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNG",
        "first_name": "LYLY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CA",
            "license": "10244TPL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0102441",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.