Individual provider Active NPI

Michelle W Wu, O.D.

  • Optometrist
  • Arcadia, CA
National Provider Identifier
1730169988
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11980T Issued in CA
Practice address
655 W Duarte Rd
Suite B
Arcadia, CA 91007-7332
Phone
(626) 446-2028
NPI assigned
Jan 21, 2006
Last updated
May 22, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11980T CA Primary

Addresses

Primary practice location

655 W Duarte Rd
Suite B
Arcadia, CA 91007-7332

Mailing address

655 W Duarte Rd
Suite B
Arcadia, CA 91007-7332
Phone (626) 446-2028

Other identifiers 1

IdentifierTypeStateIssuer
SD0119800MedicaidCA

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
I20050912000795 CA Practitioner - Optometry 0941237879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Vision PCGroup PAC ID 9234472242, 115 clinicians

Practice addresses (Care Compare)

12461 W Washington Blvd
Los Angeles, CA 90066-5511
Phone (310) 390-6287

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11980TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Total Vision PC Optometrist CurrentSince Nov 19, 2021 Accepting new patients
Marina Eyecare Center Optometrist Past Accepting new patients
Steven T Klein OD & Kimberly Plattner OD a Professional Corporation Optometrist Past Accepting new patients

Locations

655 W Duarte Rd
#B
Arcadia, CA 91007
Phone (626) 446-2028

19459 Stevens Creek Blvd
Ste 110
Cupertino, CA 95014
Phone (408) 996-9886

12461 W Washington Blvd
Los Angeles, CA 90066
Phone (310) 390-6287

27271 Las Ramblas
Ste 210
Mission Viejo, CA 92691

11717 Bernardo Plaza Ct
Ste 105
San Diego, CA 92128
Phone (858) 487-5555

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1137801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1730169988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 W DUARTE RD",
            "address_2": "SUITE B",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910077332",
            "telephone_number": "626-446-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W DUARTE RD",
            "address_2": "SUITE B",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910077332",
            "telephone_number": "626-446-2028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "MICHELLE",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-21",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11980T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0119800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

Verify at the official NPI Registry.