Individual provider Active NPI

Karen Ly Wu, OD

  • Optometrist
  • Irvine, CA
National Provider Identifier
1467025791
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34863 Issued in CA
Practice address
78 Tallowood
Irvine, CA 92620-3113
Phone
(408) 500-5621
NPI assigned
Jul 23, 2021
Last updated
Jul 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34863 CA Primary

Addresses

Primary practice location

78 Tallowood
Irvine, CA 92620-3113

Mailing address

78 Tallowood
Irvine, CA 92620-3113
Phone (408) 500-5621

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
I20230222002926 CA Practitioner - Optometry 2769850981 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fifth Optometric Care of California Optometrist Current Accepting new patients
Fifth Optometric Care of California Optometrist CurrentSince Nov 13, 2023 Accepting new patients
Fifth Optometric Care of California Optometrist CurrentSince Nov 13, 2023 Accepting new patients

Locations

22681 Lake Forest Dr
Ste A2
Lake Forest, CA 92630
Phone (949) 837-2121

3333 Quality Dr
Rncho Cordova, CA 95670
Phone (704) 712-0564

Organizations & group practices 3

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": "1626998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1467025791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 TALLOWOOD",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926203113",
            "telephone_number": "408-500-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 TALLOWOOD",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926203113",
            "telephone_number": "408-500-5621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "KAREN",
        "middle_name": "LY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-23",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.