Individual provider Active NPI

Andrew Mah, O.D.

  • Optometrist
  • San Ramon, CA
National Provider Identifier
1497286496
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
33628 Issued in CA
Practice address
2837 Yosemite Ave
San Ramon, CA 94583-3438
Phone
(925) 818-5704
NPI assigned
Mar 22, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 33628 CA Primary
Optometrist 152W00000X 60707338 WA

Addresses

Primary practice location

2837 Yosemite Ave
San Ramon, CA 94583-3438

Mailing address

2837 Yosemite Ave
San Ramon, CA 94583-3438

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
I20171023002204 CA Practitioner - Optometry 4587941455 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60707338WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Doris H Wong Optometric Corporation Optometrist CurrentSince Aug 11, 2017 Accepting new patients

Locations

175 Market Pl
San Ramon, CA 94583
Phone (925) 275-0202

Interoperability endpoints

  • Direct secure messaging: amah@mhec.updoxdirect.com

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": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1497286496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2837 YOSEMITE AVE",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945833438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2837 YOSEMITE AVE",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945833438",
            "telephone_number": "925-818-5704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAH",
        "first_name": "ANDREW",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-22",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33628",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "60707338",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ramon, CA

Sources for this page

Verify at the official NPI Registry.