Individual provider Active NPI

Clarissa Sin, O.D.

  • Optometrist
  • San Mateo, CA
National Provider Identifier
1619106903
Registry record updated Dec 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13768 Issued in CA
Practice address
117 N San Mateo Dr
Suite 2
San Mateo, CA 94401-2708
Phone
(650) 344-2555
Fax
(650) 344-1702
NPI assigned
Jul 7, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13768 CA Primary

Addresses

Primary practice location

117 N San Mateo Dr
Suite 2
San Mateo, CA 94401-2708

Mailing address

2918 Sorrento Way
Suite 2
Union City, CA 94587-1532
Phone (510) 475-0778

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
I20110606000175 CA Practitioner - Optometry 7214114065 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fremont Optometric Group Optometrist CurrentSince Feb 5, 2016 Accepting new patients
Clarissa Sin OD, Inc Optometrist Past Accepting new patients

Locations

39355 California St
Ste 103
Fremont, CA 94538
Phone (510) 744-2010

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482883200000",
    "number": "1619106903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2918 SORRENTO WAY",
            "address_2": "SUITE 2",
            "city": "UNION CITY",
            "state": "CA",
            "postal_code": "945871532",
            "telephone_number": "510-475-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 N SAN MATEO DR",
            "address_2": "SUITE 2",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012708",
            "telephone_number": "650-344-2555",
            "fax_number": "650-344-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIN",
        "first_name": "CLARISSA",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-07",
        "last_updated": "2016-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

Verify at the official NPI Registry.