Individual provider Active NPI

Ivan Young Tsai, O.D.

  • Optometrist
  • Huntington Beach, CA
National Provider Identifier
1427023068
Registry record updated Feb 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11335T Issued in CA
Practice address
5890 Edinger Ave
Huntington Beach, CA 92649-1705
Phone
(714) 840-2020
Fax
(714) 840-2025
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11335T CA Primary

Addresses

Primary practice location

5890 Edinger Ave
Huntington Beach, CA 92649-1705

Mailing address

5890 Edinger Ave
Huntington Beach, CA 92649-1705
Phone (714) 840-2020

Other identifiers 3

IdentifierTypeStateIssuer
Y16365OtherCAMEDICARE GROUP UPIN
SD11335T0OtherCABLUE SHIELD PROVIDER PIN
W17925OtherCAMEDICARE GROUP PIN

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
I20040909000883 CA Practitioner - Optometry 6204802481 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5890 Edinger Ave
Huntington Beach, CA 92649-1705
Phone (714) 840-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11335CAMDClinical Social Worker
11335TCAMDOptometrist

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392768000000",
    "number": "1427023068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5890 EDINGER AVE",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926491705",
            "telephone_number": "714-840-2020",
            "fax_number": "714-840-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5890 EDINGER AVE",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926491705",
            "telephone_number": "714-840-2020",
            "fax_number": "714-840-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSAI",
        "first_name": "IVAN",
        "middle_name": "YOUNG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2014-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11335T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP UPIN",
            "identifier": "Y16365",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER PIN",
            "identifier": "SD11335T0",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "W17925",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.