Individual provider Active NPI

Sonya Minha Park, M.D.

  • Optometrist
  • Cupertino, CA
National Provider Identifier
1609819614
Registry record updated May 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT14382-TPL Issued in CA
Practice address
10300 S de Anza Blvd
Cupertino, CA 95014-3030
Phone
(408) 252-7310
Fax
(408) 257-8355
NPI assigned
Jun 14, 2006
Last updated
May 4, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 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 4527 MA
Optometrist 152W00000X OPT14382-TPL CA Primary

Addresses

Primary practice location

10300 S de Anza Blvd
Cupertino, CA 95014-3030

Mailing address

393 Blossom Hill Rd
Ste 265
San Jose, CA 95123-1652
Phone (408) 227-7122

Other identifiers 2

IdentifierTypeStateIssuer
4527OtherMALICENSE
OPT14382-TPLOtherCACA LICENSE

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
I20140411001051 CA Practitioner - Optometry 5597856708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Eye Physicians a Medical CorporationGroup PAC ID 2961459094, 15 clinicians

Practice addresses (Care Compare)

2577 Samaritan Dr
Suite 740
San Jose, CA 95124-4105
Phone (408) 358-2029

Merit-based Incentive Payment System (MIPS)

Final score
87.11 of 100Reported as group
Quality
88.99
Improvement activities
40
Cost
71.73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
OPT14382-TPLCAMDOptometrist
4527MAMDOptometrist
14382CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Eye Physicians, a Medical Corporation Optometrist CurrentSince May 1, 2014 Accepting new patients
Spectrum Eye Physicians, a Medical Corporation Optometrist CurrentSince May 1, 2014 Accepting new patients

Locations

10300 S De Anza Blvd
Cupertino, CA 95014
Phone (408) 252-7310

10300 S De Anza Blvd
Ste A
Cupertino, CA 95014
Phone (408) 253-3083

431 Monterey Ave
Ste 3
Los Gatos, CA 95030
Phone (408) 354-9510

2577 Samaritan Dr
Ste 740
San Jose, CA 95124
Phone (408) 252-7310

393 Blossom Hill Rd
Ste 265
San Jose, CA 95123
Phone (408) 227-7122

1663 Dominican Way
Ste 212
Santa Cruz, CA 95065
Phone (831) 226-2636

Organizations & group practices 2

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493856000000",
    "number": "1609819614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 BLOSSOM HILL RD",
            "address_2": "STE 265",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951231652",
            "telephone_number": "408-227-7122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 S DE ANZA BLVD",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950143030",
            "telephone_number": "408-252-7310",
            "fax_number": "408-257-8355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SONYA",
        "middle_name": "MINHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2017-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4527",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT14382-TPL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4527",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LICENSE",
            "identifier": "OPT14382-TPL",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cupertino, CA

Sources for this page

Verify at the official NPI Registry.