Individual provider Active NPI

Soo Jin Noh, O.D.

  • Optometrist
  • Sacramento, CA
National Provider Identifier
1326474602
Registry record updated Oct 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT 14698 TLG Issued in CA
Practice address
400 O St
Ste 102
Sacramento, CA 95814-5327
Phone
(916) 443-3524
NPI assigned
Sep 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT 14698 TLG CA Primary

Addresses

Primary practice location

400 O St
Ste 102
Sacramento, CA 95814-5327

Mailing address

400 O St
Ste 102
Sacramento, CA 95814-5327
Phone (916) 443-3524

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
I20161107002253 CA Practitioner - Optometry 2264734755 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT 14698 TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sacramento Optometric Group, a Professional Corporation Optometrist CurrentSince Feb 22, 2017 Accepting new patients
Third Optometric Care of California PC Optometrist CurrentSince May 22, 2021 Accepting new patients
Third Optometric Care of California PC Optometrist CurrentSince May 22, 2021 Accepting new patients
Third Optometric Care of California Optometrist Current Accepting new patients
Advanced Eyecare Professional Optometric Group Optometrist CurrentSince Sep 17, 2016 Accepting new patients

Locations

330 N Brand Blvd
Ste 110
Glendale, CA 91203
Phone (818) 240-0890

1055 Foothill Blvd
La Canada, CA 91011

3333 Quality Dr
Rncho Cordova, CA 95670
Phone (704) 712-0564

400 O St
Ste 102
Sacramento, CA 95814
Phone (916) 443-3524

6702 Inglewood Ave
Ste H
Stockton, CA 95207
Phone (209) 951-3937

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.

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Third Optometric Care of California 16 clinicians

Practice addresses (Care Compare)

400 O St
Suite 102
Sacramento, CA 95814-5327
Phone (916) 443-3524

NPI Registry JSON

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

{
    "created_epoch": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476921600000",
    "number": "1326474602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 O ST",
            "address_2": "STE 102",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958145327",
            "telephone_number": "916-443-3524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 O ST",
            "address_2": "STE 102",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958145327",
            "telephone_number": "916-443-3524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOH",
        "first_name": "SOO JIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-19",
        "last_updated": "2016-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 14698 TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.