Stacey T. Gin, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

13022 Issued in CA

Practice address

308 E Broadway
Glendale, CA 91205-1011

Phone

(818) 243-1300

Fax

(818) 243-1583

NPI assigned

Aug 25, 2006

Sex

Female

Sole proprietor

Yes

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

Southern California College of Optometry, 2006

Medicare assignment

May accept Medicare assignment

Group practices

Huntington Optometric CenterGroup PAC ID 7911237375, 6 clinicians

Glendale Optometric CenterGroup PAC ID 2365532561, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Glendale Optometric Center

  • Optometrist
  • Glendale, CA
  • NPI 1801093653
  Medicare reassignment Care Compare group NPD Authorized official
• Huntington Optometric Center

  • Optometrist
  • Alhambra, CA
  • NPI 1902452188
  Medicare reassignment Care Compare group NPD
• Duane Decroupet OD a PC

  • Optometrist
  • Glendale, CA
  • NPI 1730258476
  NPD (past)

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1619085149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 E BROADWAY",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051011",
            "telephone_number": "818-243-1300",
            "fax_number": "818-243-1583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 E BROADWAY",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051011",
            "telephone_number": "818-243-1300",
            "fax_number": "818-243-1583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIN",
        "first_name": "STACEY",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harlan Gibbs, M.D.
• Gift of Comfort Hospice, Inc.
• Gilbert Garcia
• Gary Guy Gilbert, M.D.
• Steven H Gimian, LSW
• Lilit Ginosyan Hayrapetyan
• Dennis Giron Licardie
• Vanessa Giron
• Matthew Giuntini, PTA
• Matthew Masoud Givrad, PHD, PSYD

• Optometrist in Glendale, CA
• Providers in Glendale, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; 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.