Matt Siu, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

34420TLG Issued in CA

Practice address

7075 Redwood Blvd
Ste F
Novato, CA 94945-4136

Phone

(415) 897-2997

NPI assigned

Jul 4, 2016

Last updated

May 30, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, CA2 enrollments

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 2

Specialty

Optometry

Education

State University of New York - State College Optometry, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tania Mantua and Matt H Siu OD a Professional CorporationGroup PAC ID 2860556768, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tania Mantua & Matt H Siu OD a Professional Corporation

  dba EyeWish Optometry

  • Optometrist
  • Novato, CA
  • NPI 1376762229
  Medicare reassignment Care Compare group NPD
• Professional Vision of Ellicott City, Inc.

  • Optometrist
  • Ellicott City, MD
  • NPI 1952796187
  Medicare reassignment NPD
• Diana Yuen, O.D.

  • Optometrist
  • Oakland, CA
  • NPI 1528128469
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1467590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1255783106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7075 REDWOOD BLVD",
            "address_2": "STE F",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949454136",
            "telephone_number": "415-897-2997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7075 REDWOOD BLVD",
            "address_2": "STE F",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949454136",
            "telephone_number": "415-897-2997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIU",
        "first_name": "MATT",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-04",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2544",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34420TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Marie Simmons, B.S.
• Ira R Simon, DDS
• James Stephen Simon, M.D.
• Briana Sinatra, ND
• Pradeep Singh, M.D.
• Jay Glenn Skelton
• Elizabeth Skirbe
• Christine C Sleight, CCC-SLP
• Jeremy Smith-Batha
• Debra May Smith

• Optometrist in Novato, CA
• Providers in Novato, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.