Individual provider Active NPI

Peter Tien, O.D.

  • Optometrist
  • Arcadia, CA
National Provider Identifier
1710339114
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
33489 Issued in CA
Practice address
622 W Duarte Rd Ste 101
Arcadia, CA 91007-9266
Phone
(626) 254-9010
Fax
(626) 254-9019
NPI assigned
Jul 8, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 33489 CA Primary

Addresses

Primary practice location

622 W Duarte Rd Ste 101
Arcadia, CA 91007-9266

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-5200

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20220316003872 CA Practitioner - Optometry 4082009634 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jules Stein Eye Institute Medical GroupGroup PAC ID 5597663740, 118 clinicians

Practice addresses (Care Compare)

622 W Duarte Rd
Suite 101
Arcadia, CA 91007-7606
Phone (323) 442-7122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33489CAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Jules Stein Eye Institute Medical Group CurrentSince May 1, 2025 Accepting new patients
Jules Stein Eye Institute Medical Group CurrentSince May 1, 2025 Accepting new patients
Brand Surgery Center, LLC Past Accepting new patients
Specialty Eye Care Medical Center, Inc. PastSince Aug 4, 2024 Accepting new patients

Locations

622 W Duarte Rd
Ste 101
Arcadia, CA 91007
Phone (310) 206-1166

18111 Brookhurst St
Ste 6400
Fountain Vly, CA 92708
Phone (714) 350-7258

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

Interoperability endpoints

  • Direct secure messaging: ptien1360912@direct.uclahealth.org

Organizations & group practices 4

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": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1710339114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W DUARTE RD STE 101",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910079266",
            "telephone_number": "626-254-9010",
            "fax_number": "626-254-9019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIEN",
        "first_name": "PETER",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-08",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33489",
            "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": "1011 Baldwin Park Blvd",
            "city": "Baldwin Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917065806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

Verify at the official NPI Registry.