Individual provider Active NPI

Kelly Tang

  • Optometrist
  • South Pasadena, CA
National Provider Identifier
1629700125
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
35160 Issued in CA
Practice address
1024 Mission St Ste B
South Pasadena, CA 91030-3198
Phone
(626) 460-6022
NPI assigned
Jun 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 35160 CA Primary
Optometrist 152W00000X 046011635 IL

Addresses

Primary practice location

1024 Mission St Ste B
South Pasadena, CA 91030-3198

Mailing address

1024 Mission St Ste B
South Pasadena, CA 91030-3198

Other practice location 1

8210 Santa Monica Blvd
West Hollywood, CA 90046-5913
Phone (323) 656-9550

Other practice location 2

8471 Beverly Blvd Ste 105
Los Angeles, CA 90048-3452
Phone (310) 360-8218

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
I20231206004112 CA Practitioner - Optometry 1850740572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meredith a Barber OD IncGroup PAC ID 0244562023, 2 clinicians

Practice addresses (Care Compare)

8471 Beverly Blvd
Suite 105
Los Angeles, CA 90048-3452
Phone (310) 360-8220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046011635ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Meredith a. Barber, O.D., Inc. Optometrist CurrentSince Oct 23, 2023 Accepting new patients
Hripsime Shirvanian, O.D., Optometry, Inc. Optometrist CurrentSince Jun 27, 2026 Accepting new patients
Jaime Chan OD a Professional Corporation Optometrist CurrentSince Jun 27, 2026 Accepting new patients
Professional Visioncare of West Hollywood, Inc a Professional Optom Optometrist PastSince Mar 15, 2009 Accepting new patients

Locations

8471 Beverly Blvd
Ste 105
Los Angeles, CA 90048
Phone (310) 360-8218

Organizations & group practices 4

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": "1656028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1629700125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 MISSION ST STE B",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910303198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 MISSION ST STE B",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910303198",
            "telephone_number": "626-460-6022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8210 Santa Monica Blvd",
            "address_purpose": "LOCATION",
            "city": "West Hollywood",
            "state": "CA",
            "postal_code": "900465913",
            "country_code": "US",
            "telephone_number": "323-656-9550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8471 Beverly Blvd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900483452",
            "country_code": "US",
            "telephone_number": "310-360-8218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANG",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-24",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35160",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011635",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Pasadena, CA

Sources for this page

Verify at the official NPI Registry.