Individual provider Active NPI

Raymond S Chin, OD

  • Optometrist
  • Santa Clara, CA
National Provider Identifier
1245200773
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11116T Issued in CA
Practice address
770 Scott Blvd
Santa Clara, CA 95050-6927
Phone
(408) 296-0511
Fax
(408) 296-1647
NPI assigned
Jan 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11116T CA Primary

Addresses

Primary practice location

770 Scott Blvd
Santa Clara, CA 95050-6927

Mailing address

1227 Manet Dr
Sunnyvale, CA 94087-2822
Phone (408) 746-0768

Other identifiers 1

IdentifierTypeStateIssuer
11116TOtherCACA LICENSE NUMBER

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
I20070807000240 CA Practitioner - Optometry 1557452414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Silicon Valley Eyecare Optometry and Contact LensesGroup PAC ID 4385735240, 7 clinicians

Practice addresses (Care Compare)

770 Scott Blvd
Santa Clara, CA 95050-6927
Phone (408) 296-0511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11116TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Silicon Valley Eyecare Optometry and Contact Lenses Optometrist CurrentSince Mar 29, 2007 Accepting new patients

Locations

770 Scott Blvd
Santa Clara, CA 95050
Phone (408) 296-0511

Interoperability endpoints

  • Direct secure messaging: rchin@siliconvalleyeyecare.eyeclinicdirect.net

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1245200773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1227 MANET DR",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940872822",
            "telephone_number": "408-746-0768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 SCOTT BLVD",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950506927",
            "telephone_number": "408-296-0511",
            "fax_number": "408-296-1647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIN",
        "first_name": "RAYMOND",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11116T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LICENSE NUMBER",
            "identifier": "11116T",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clara, CA

Sources for this page

Verify at the official NPI Registry.