Individual provider Active NPI

Rebecca D Bui Van, O.D.

  • Optometrist
  • Carmichael, CA
National Provider Identifier
1245323179
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11298 Issued in CA
Practice address
4005 Manzanita Ave Ste 57
Carmichael, CA 95608-1784
Phone
(916) 483-6661
Fax
(916) 514-8637
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Vision Optometrist 152WX0102X 112098T CA
Optometrist 152W00000X 11298 CA Primary

Addresses

Primary practice location

4005 Manzanita Ave Ste 57
Carmichael, CA 95608-1784

Mailing address

4005 Manzanita Ave Ste 57
Carmichael, CA 95608-1784
Phone (916) 483-6661

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
I20090808000159 CA Practitioner - Optometry 7719872332 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

Practice addresses (Care Compare)

4005 Manzanita Ave
Suite 57
Carmichael, CA 95608-1784
Phone (916) 483-6661

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
112098TCAMDOccupational Vision Optometrist
11298CAMDAcupuncturist

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1245323179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4005 MANZANITA AVE STE 57",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956081784",
            "telephone_number": "916-483-6661",
            "fax_number": "916-483-6664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 MANZANITA AVE STE 57",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956081784",
            "telephone_number": "916-483-6661",
            "fax_number": "916-514-8637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUI VAN",
        "first_name": "REBECCA",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "CA",
            "license": "112098T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmichael, CA

Sources for this page

Verify at the official NPI Registry.