Individual provider Active NPI

Peter D Huang, O.D.

  • Optometrist
  • Chula Vista, CA
National Provider Identifier
1639100522
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11659TPL Issued in CA
Practice address
557 H St
Ste B
Chula Vista, CA 91910-4340
Phone
(619) 422-0139
Fax
(619) 422-0066
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11659TPL CA Primary

Addresses

Primary practice location

557 H St
Ste B
Chula Vista, CA 91910-4340

Mailing address

557 H St
Ste B
Chula Vista, CA 91910-4340
Phone (619) 422-0139

Other identifiers 1

IdentifierTypeStateIssuer
SD0116590MedicaidCA

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
I20100916001143 CA Practitioner - Optometry 6507981396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

557 H St
B
Chula Vista, CA 91910-4330
Phone (619) 422-0139

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11659TPLCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Peter D Huang, O.D. a Professional Corporation CurrentSince Apr 20, 2002 Accepting new patients

Locations

557 H St
Ste B
Chula Vista, CA 91910
Phone (619) 422-0139

557 H St
#B
Chula Vista, CA 91910
Phone (619) 422-0139

Organizations & group practices 1

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1639100522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 H ST",
            "address_2": "STE B",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104340",
            "telephone_number": "619-422-0139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 H ST",
            "address_2": "STE B",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104340",
            "telephone_number": "619-422-0139",
            "fax_number": "619-422-0066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUANG",
        "first_name": "PETER",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11659TPL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0116590",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.