Individual provider Active NPI

Lisa Masuyama, OD

  • Optometrist
  • Artesia, CA
National Provider Identifier
1396226395
Registry record updated Aug 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34080TLG Issued in CA
Practice address
17801 Pioneer Blvd Ste F
Artesia, CA 90701-3962
Phone
(562) 467-0813
NPI assigned
Aug 27, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34080TLG CA Primary

Addresses

Primary practice location

17801 Pioneer Blvd Ste F
Artesia, CA 90701-3962

Mailing address

17008 Haas Ave
Torrance, CA 90504-2209
Phone (310) 701-3804

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
I20180928000274 CA Practitioner - Optometry 9133470263 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34080CAMDChiropractor
34080TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Ardaya & Lin Optometry Inc Optometrist CurrentSince Nov 1, 2022 Accepting new patients
Sheldon M. Golden OD Optometric Corporation Optometrist Past Accepting new patients

Locations

1026 W West Covina Pkwy
Ste B
West Covina, CA 91790
Phone (626) 593-4234

11245 Washington Blvd
Whittier, CA 90606
Phone (562) 692-1208

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1396226395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17008 HAAS AVE",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905042209",
            "telephone_number": "310-701-3804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17801 PIONEER BLVD STE F",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "907013962",
            "telephone_number": "562-467-0813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASUYAMA",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-27",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34080TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Artesia, CA

Sources for this page

Verify at the official NPI Registry.