Patricia B. Tang, O.D.
Individual provider Active NPI Optometrist · Colma, CA
NPI 1336494590 · NPPES record last updated Jul 13, 2012
Key facts
- NPI
- 1336494590
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 14477 (CA)
- Practice address
- 53 Colma Blvd
Colma, CA 94014-3231 - Phone
- (650) 992-2700
- NPI assigned
- Jul 13, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Marin Ophthalmic Consultants, a Medical Corporation
Practice addresses (Care Compare)
901 E St
Suite 285
San Rafael, CA 94901-2850
Phone (415) 454-5565
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171228002454 | CA | Practitioner - Optometry | 5395003008 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14477 | CA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marin Ophthalmic Consultants, a Medical Corporation | Current | Accepting new patients | |
| Marin Ophthalmic Consultants | Current |
Accepting new patients | |
| Luxottica of America Inc. | Past | Accepting new patients |
Locations
901 E St
Ste 285
San Rafael, CA 94901
Phone (415) 454-5565
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- patricia.tang.p1@direct.marineyes.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 14477 | CA | Yes |
Addresses
Primary practice location
53 Colma Blvd
Colma, CA 94014-3231
Mailing address
1724 23Rd Ave
San Francisco, CA 94122-4424
Other providers in Colma, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.