Individual provider Active NPI

Lyle Kent Tsuji, O.D.

  • Optometrist
  • Berkeley, CA
National Provider Identifier
1700929072
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7594 Issued in CA
Practice address
2174 Shattuck Ave
Berkeley, CA 94704-1307
Phone
(510) 841-6963
Fax
(510) 548-1822
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7594 CA Primary

Addresses

Primary practice location

2174 Shattuck Ave
Berkeley, CA 94704-1307

Mailing address

1319 Kains Ave
Berkeley, CA 94702-1015
Phone (510) 527-6613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700929072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 KAINS AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947021015",
            "telephone_number": "510-527-6613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2174 SHATTUCK AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041307",
            "telephone_number": "510-841-6963",
            "fax_number": "510-548-1822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSUJI",
        "first_name": "LYLE",
        "middle_name": "KENT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.