Kelvin Scott Sue, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

9768T Issued in CA

Practice address

1200 K St
Suite 6
Sacramento, CA 95814-3950

Phone

(916) 442-0419

Fax

(916) 492-2203

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210896000000",
    "number": "1740376375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 K ST",
            "address_2": "SUITE 6",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958143950",
            "telephone_number": "916-442-0419",
            "fax_number": "916-492-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 K ST",
            "address_2": "SUITE 6",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958143950",
            "telephone_number": "916-442-0419",
            "fax_number": "916-492-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUE",
        "first_name": "KELVIN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2008-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9768T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0097680",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lowell Suckow, M.D
• Ashish Sud
• Leanna Sudhof, MD
• Elena Vasil Sudjian, MD
• Tracy Iris Sudler, LVN
• Aviva Suero, B.S.,P.T.
• Michael Taylor Suflita, MD
• Rosanna Sugar
• Michael M Sugawara, M.D.
• Laurie Suggs

• Optometrist in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.