Individual provider Active NPI

Grace T Wu, MD

  • Ophthalmology Physician
  • Orange, CA
National Provider Identifier
1306092424
Registry record updated Apr 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
129362 Issued in CA
Practice address
991 N Tustin St
Suite 101
Orange, CA 92867-5900
Phone
(714) 639-6162
NPI assigned
Aug 8, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125054643 IL
Ophthalmology Physician 207W00000X 129362 CA Primary

Addresses

Primary practice location

991 N Tustin St
Suite 101
Orange, CA 92867-5900

Mailing address

991 N Tustin St
Suite 101
Orange, CA 92867-5900
Phone (714) 639-6162

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160713000876 CA Practitioner - Ophthalmology 8123310067 Practice locations: Orange, CA

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Northwestern University Feinberg Medical School, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

991 N Tustin St
Suite 101
Orange, CA 92867-5900
Phone (714) 639-6162

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125054643ILMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1218153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396396800000",
    "number": "1306092424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "991 N TUSTIN ST",
            "address_2": "SUITE 101",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928675900",
            "telephone_number": "714-639-6162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "991 N TUSTIN ST",
            "address_2": "SUITE 101",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928675900",
            "telephone_number": "714-639-6162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "GRACE",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-08",
        "last_updated": "2014-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125054643",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "129362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.