Erika Seoyeon Park, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

34998 Issued in CA

Practice address

117 Pelton Center Way
San Leandro, CA 94577-4815

Phone

(510) 895-2116

NPI assigned

Sep 15, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

University of California - School of Optometry, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iron Horse Optometric GroupGroup PAC ID 1557582079, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Iron Horse Optometric Group

  • Optometrist
  • Dublin, CA
  • NPI 1265840672
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1508536293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 HARRISON ST APT 667",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946073875",
            "telephone_number": "512-529-7606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 PELTON CENTER WAY",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774815",
            "telephone_number": "510-895-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "ERIKA",
        "middle_name": "SEOYEON",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthias Parish
• Andy Park, BCBA
• Chris Junbum Park, DDS
• Connie Jung Park, MD
• David Kyung-Il Park, M.D.
• Jeong Ho Park
• Jun Wan Park
• Richard Allen Park, M.D.
• Sung-Keun Park, M.D.
• Jabeen Abdulla Parkar, M.D.

• Optometrist in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.