Individual provider Active NPI

Sharon Liao, OD

  • Optometrist
  • Upland, CA
National Provider Identifier
1669979001
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34487TLG Issued in CA
Practice address
555 N 13TH Ave
Upland, CA 91786-4904
Phone
(909) 982-8846
NPI assigned
Apr 11, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34487TLG CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

555 N 13TH Ave
Upland, CA 91786-4904

Mailing address

555 N 13TH Ave
Upland, CA 91786-4904

Other practice location 1

2265 Maywind Way
Hacienda Heights, CA 91745-5518
Phone (626) 374-6802

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
I20200511003040 CA Practitioner - Optometry 1355772138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Eye Institute a Medical Group IncGroup PAC ID 7911966122, 43 clinicians

Practice addresses (Care Compare)

555 N 13TH Ave
Upland, CA 91786-4904
Phone (909) 982-8846

Merit-based Incentive Payment System (MIPS)

Final score
80.15 of 100Reported as group
Quality
76.08
Promoting interoperability
72
Improvement activities
40
Cost
75.13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34487TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Eye Institute a Medical Group Inc CurrentSince Apr 5, 2020 Accepting new patients
Pacific Eye Institute, a Medical Group, Inc. CurrentSince Apr 5, 2020 Accepting new patients

Locations

15099 Kamana Rd
Apple Valley, CA 92307

8112 Milliken Ave
Ste 203
Rancho Cucamonga, CA 91730
Phone (909) 945-3563

9481 Haven Ave
Ste 200
Rancho Cucamonga, CA 91730
Phone (909) 937-9230

41877 Enterprise Cir N
Ste 110
Temecula, CA 92590
Phone (951) 296-2244

555 N 13th Ave
Upland, CA 91786
Phone (909) 982-8846

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1669979001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 N 13TH AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 N 13TH AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864904",
            "telephone_number": "909-982-8846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2265 Maywind Way",
            "address_purpose": "LOCATION",
            "city": "Hacienda Heights",
            "state": "CA",
            "postal_code": "917455518",
            "country_code": "US",
            "telephone_number": "626-374-6802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIAO",
        "first_name": "SHARON",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34487TLG",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.