Individual provider Active NPI

Kyung Eun Min, OD

  • Optometrist
  • Pasadena, CA
National Provider Identifier
1629418983
Registry record updated Feb 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
33588TLG Issued in CA
Practice address
477 E Colorado Blvd
Pasadena, CA 91101-2024
Phone
(626) 796-1191
NPI assigned
Jul 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 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 27OA00647400 NJ
Optometrist 152W00000X 33588TLG CA Primary

Addresses

Primary practice location

477 E Colorado Blvd
Pasadena, CA 91101-2024

Mailing address

477 E Colorado Blvd
Pasadena, CA 91101-2024
Phone (626) 796-1191

Other names 1

  • Michelle Min Other name

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
I20170105000759 CA Practitioner - Optometry 7719121359 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33588TLGCAMDOptometrist
27OA00647400NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Linden Optometry a Professional Corporation Optometrist CurrentSince Nov 27, 2016 Accepting new patients
Dr. Arlene T. Yepremian, O.D. a Professional Corporation Optometrist PastSince Nov 27, 2016 Accepting new patients
Steven J. Chiana, O.D. Inc. Optometrist Past Accepting new patients

Locations

477 E Colorado Blvd
Pasadena, CA 91101
Phone (626) 796-1191

Organizations & group practices 3

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": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486080000000",
    "number": "1629418983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 E COLORADO BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012024",
            "telephone_number": "626-796-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 E COLORADO BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012024",
            "telephone_number": "626-796-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIN",
        "first_name": "KYUNG EUN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-01",
        "last_updated": "2017-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00647400",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33588TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "MIN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.