Individual provider Active NPI

Thomas L Lim, O.D.

  • Optometrist
  • San Jose, CA
National Provider Identifier
1346218518
Registry record updated Jun 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6280T Issued in CA
Practice address
2534 Berryessa Rd
San Jose, CA 95132-2903
Phone
(408) 272-7200
Fax
(408) 272-3310
NPI assigned
Mar 14, 2006
Last updated
Jun 1, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6280T CA Primary

Addresses

Primary practice location

2534 Berryessa Rd
San Jose, CA 95132-2903

Mailing address

2534 Berryessa Rd
San Jose, CA 95132-2903
Phone (408) 272-7200

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
I20040923000847 CA Practitioner - Optometry 3971571233 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6280TCAMDOptometrist
6280CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Berryessa Optometry, a Professional Corp Optometrist CurrentSince Jul 1, 2008 Accepting new patients

Locations

2534 Berryessa Rd
San Jose, CA 95132
Phone (408) 272-7200

Organizations & group practices 1

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243814400000",
    "number": "1346218518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2534 BERRYESSA RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951322903",
            "telephone_number": "408-272-7200",
            "fax_number": "408-272-3310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2534 BERRYESSA RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951322903",
            "telephone_number": "408-272-7200",
            "fax_number": "408-272-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "THOMAS",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2009-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6280T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.