Stacey Lu

Primary specialty

OptometristTaxonomy code 152W00000X

License

34050TLG Issued in CA

Practice address

280 Exempla Cir
Lafayette, CO 80026-3370

Phone

(303) 338-4545

NPI assigned

Mar 17, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, shared by 4 NPIs, 11,250 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Fontana, CA
  • NPI 1689606196
  NPD
• Southern California Permanente Medical Group

  dba Target Clinic Medical Associates of Southern California

  • Health Maintenance Organization
  • Rosemead, CA
  • NPI 1942787114
  NPD

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

{
    "created_epoch": "1521244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1639672421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 E DAKOTA AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802471314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 EXEMPLA CIR",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800263370",
            "telephone_number": "303-338-4545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4560 E Cesar E Chavez Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900221168",
            "country_code": "US",
            "telephone_number": "323-980-9900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3801 Miranda Ave",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943041207",
            "country_code": "US",
            "telephone_number": "650-493-5000 x62020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LU",
        "first_name": "STACEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-17",
        "last_updated": "2022-11-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34050TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Camma Love, OTR/L
• Lawren Love, M.D.
• Brittain Lovett
• Travis Matt Loyd, DPT
• Jesus Loza Salinas, DDS
• Charles J Lucas, RPH
• Virginia Anne Lucas, LCSW
• Joseph Lucero, D.D.S.
• Kelly Luck
• Esther H Lum, M.D.

• Optometrist in Lafayette, CO
• Providers in Lafayette, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.