Individual provider Active NPI

Simon Lai, O.D.

  • Optometrist
  • San Francisco, CA
National Provider Identifier
1710392204
Registry record updated Jun 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14990 Issued in CA
Practice address
781 Vallejo St
San Francisco, CA 94133-3834
Phone
(415) 677-9930
NPI assigned
Jun 24, 2014
Last updated
Jun 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 14990 CA Primary

Addresses

Primary practice location

781 Vallejo St
San Francisco, CA 94133-3834

Mailing address

1833 44TH Ave
San Francisco, CA 94122-4015

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
I20140801000536 CA Practitioner - Optometry 7416173158 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North East Medical Services CurrentSince Nov 1, 2021 Accepting new patients
North East Medical Services CurrentSince Nov 1, 2021 Accepting new patients
Crystal Clear Vision Center Optometrist PastSince Jul 31, 2014 Accepting new patients
North East Medical Services PastSince Dec 28, 2022 Accepting new patients

Locations

211 Eastmoor Ave
Daly City, CA 94015
Phone (650) 550-3923

1430 Noriega St
San Francisco, CA 94122

1520 Stockton St
San Francisco, CA 94133

2574 San Bruno Ave
San Francisco, CA 94134
Phone (415) 750-5909

82 Leland Ave
San Francisco, CA 94134
Phone (415) 391-9688

1870 Lundy Ave
San Jose, CA 95131
Phone (408) 573-9686

Interoperability endpoints

  • Direct secure messaging: slai18826@northeastmedicalservicesnems.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403568000000",
    "number": "1710392204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1833 44TH AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941224015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "781 VALLEJO ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941333834",
            "telephone_number": "415-677-9930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAI",
        "first_name": "SIMON",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-24",
        "last_updated": "2014-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.