Individual provider Active NPI

Tracy Thao Le, O.D.

  • Optometrist
  • San Jose, CA
National Provider Identifier
1396730719
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT11478T Issued in CA
Practice address
301 N Jackson Ave
Suite 1
San Jose, CA 95133-2344
Phone
(408) 259-1818
Fax
(408) 259-1871
NPI assigned
Sep 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT11478T CA Primary

Addresses

Primary practice location

301 N Jackson Ave
Suite 1
San Jose, CA 95133-2344

Mailing address

3331 Norwood Ave
San Jose, CA 95148-2712
Phone (408) 259-1818

Other identifiers 1

IdentifierTypeStateIssuer
SD0114780MedicaidCA

Other names 1

  • Thao Phuong Le Former name

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
I20041117001071 CA Practitioner - Optometry 3375507429 Practice locations: San Jose, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT11478TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
San Jose Eye Care Optometry Professional Corporation Optometrist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1396730719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3331 NORWOOD AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951482712",
            "telephone_number": "408-259-1818",
            "fax_number": "408-259-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N JACKSON AVE",
            "address_2": "SUITE 1",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951332344",
            "telephone_number": "408-259-1818",
            "fax_number": "408-259-1871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "TRACY",
        "middle_name": "THAO",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT11478T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0114780",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THAO",
            "last_name": "LE",
            "middle_name": "PHUONG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.