Lisa Van, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

34027TLG Issued in CA

Practice address

4220 Von Karman Ave Ste 100
Newport Beach, CA 92660-2056

Phone

(949) 431-6344

NPI assigned

Mar 30, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Clarity Eye GroupGroup PAC ID 0446287361, 7 clinicians

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.

• Clarity Eye Group

  • Ophthalmology Physician
  • Huntington Beach, CA
  • NPI 1033122957

  Optometrist

  Medicare reassignment Care Compare group NPD
• Luis a Chanes M D Inc

  • Specialist
  • Santa Ana, CA
  • NPI 1568481679
  Medicare reassignment NPD
• 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
• Thomas S Tooma M D a Professional Corporation

  • Ophthalmology Physician
  • Newport Beach, CA
  • NPI 1922129865

  Optometrist

  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Los Angeles, CA
  • NPI 1134151657
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Thomas S Tooma M D a Professional Corporation

  • Optometrist
  • San Diego, CA
  • NPI 1215583257
  NPD
• Thomas S. Tooma, M.D. a Professional Corporation

  • Ophthalmology Physician
  • Newport Beach, CA
  • NPI 1386764983
  NPD (past)

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

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1689170664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 VON KARMAN AVE STE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 VON KARMAN AVE STE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602056",
            "telephone_number": "949-431-6344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27800 Medical Center Rd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Mission Viejo",
            "state": "CA",
            "postal_code": "926916407",
            "country_code": "US",
            "telephone_number": "949-364-0225",
            "fax_number": "949-364-9014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11301 Wilshire Blvd",
            "address_2": "Eye Clinic (123) Building 304",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900731003",
            "country_code": "US",
            "telephone_number": "310-478-3711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN",
        "first_name": "LISA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-30",
        "last_updated": "2023-10-27",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34027TLG",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "NA",
            "primary": false
        }
    ],
    "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": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Vivek Ram Vallurupalli, MD
• Ellen R Van Eck, PHD
• Denise Kay Van Horn, M. D.
• Andrew Van Leuven, DPT
• Kecia Van Mechelen
• Amy Vanbecelaere, LPCC
• Stacie L Vanbodegon, AUD
• Vance B Becker Inc a Psychological Corporation
• Vance K. Vanier, PC
• William J Vandalsem, M.D.

• Optometrist in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; 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.