Individual provider Active NPI

Isabell Hyejin Choi-Siritaratiwat, OD

  • Optometrist
  • Brea, CA
National Provider Identifier
1265514269
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT13003T Issued in CA
Practice address
428 S Brea Blvd
Brea, CA 92821-5301
Phone
(714) 529-2470
Fax
(866) 801-4739
NPI assigned
Oct 19, 2006
Last updated
Mar 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT13003T CA Primary

Addresses

Primary practice location

428 S Brea Blvd
Brea, CA 92821-5301

Mailing address

24401 Calle de la Louisa Ste 300
Laguna Hills, CA 92653-3625
Phone (949) 951-2020

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
I20070412000643 CA Practitioner - Optometry 0042315434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

665 Camino de Los Mares
Suite 102 103
San Clemente, CA 92673-2859
Phone (949) 951-2020

Merit-based Incentive Payment System (MIPS)

Final score
80.67 of 100Reported as group
Quality
93.87
Promoting interoperability
100
Improvement activities
40
Cost
41.69

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT13003TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Eye Associates CurrentSince May 4, 2019 Accepting new patients
David G Kirschen OD PHD a Professional Optometric Corp Optometrist PastSince Feb 15, 2018 Accepting new patients

Locations

23961 Calle de la Magdalena
Ste 300
Laguna Hills, CA 92653
Phone (949) 837-1891

1010 W La Veta Ave
Ste 175
Orange, CA 92868
Phone (714) 633-5696

1801 W Olympic Blvd
#2096
Pasadena, CA 91199

665 Camino de los Mares
Ste 102
San Clemente, CA 92673
Phone (714) 493-7330

665 Camino de los Mares
Ste 102103
San Clemente, CA 92673
Phone (949) 951-2020

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1265514269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24401 CALLE DE LA LOUISA STE 300",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533625",
            "telephone_number": "949-951-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 S BREA BLVD",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928215301",
            "telephone_number": "714-529-2470",
            "fax_number": "866-801-4739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI-SIRITARATIWAT",
        "first_name": "ISABELL",
        "middle_name": "HYEJIN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT13003T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

Verify at the official NPI Registry.