Individual provider Active NPI

Phoebe Lo, OD

  • Optometrist
  • Hayward, CA
National Provider Identifier
1306574694
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
35166 Issued in CA
Practice address
1575 B St
Hayward, CA 94541-3017
Phone
(510) 581-1430
NPI assigned
Aug 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 35166 CA Primary

Addresses

Primary practice location

1575 B St
Hayward, CA 94541-3017

Mailing address

1100 Webster St Apt 576
Oakland, CA 94607-4599
Phone (732) 912-5052

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
I20220830004211 CA Practitioner - Optometry 7113301763 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athena Brasfield OD a Professional CorporationGroup PAC ID 0749577088, 8 clinicians

Practice addresses (Care Compare)

52565 Cesar Chavez St
Suite 105
Coachella, CA 92236-1534
Phone (760) 398-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35166CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athena Brasfield OD a Professional Corporation Optometrist CurrentSince Sep 1, 2023 Accepting new patients
V. Nicholas Batra M.D. Inc. Optometrist CurrentSince Aug 16, 2022 Accepting new patients
Affinity Medical Group PastSince Aug 12, 2022 Accepting new patients
Dr. Gregory L. McFarland, O.D., P.C Optometrist PastSince Apr 9, 2018 Accepting new patients

Locations

34131 Date Palm Dr
Ste F1
Cathedral City, CA 92234

52565 Harrison St
Ste 105
Coachella, CA 92236
Phone (760) 347-6636

82227 US Highway 111
Ste B2
Indio, CA 92201
Phone (760) 347-6636

400 S Farrell Dr
Ste B130
Palm Springs, CA 92262
Phone (760) 347-6636

15051 Hesperian Blvd
Ste A
San Leandro, CA 94578
Phone (510) 276-1212

Organizations & group practices 5

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": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1306574694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WEBSTER ST APT 576",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946074599",
            "telephone_number": "732-912-5052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 B ST",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945413017",
            "telephone_number": "510-581-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LO",
        "first_name": "PHOEBE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, CA

Sources for this page

Verify at the official NPI Registry.