Individual provider Active NPI

Thi Dong Buu, O.D.

  • Optometrist
  • Lake Elsinore, CA
National Provider Identifier
1740495183
Registry record updated Apr 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11411T Issued in CA
Practice address
25321 Railroad Canyon Rd
Suite 503
Lake Elsinore, CA 92532-2702
Phone
(951) 244-1122
Fax
(951) 244-2777
NPI assigned
May 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11411T CA Primary

Addresses

Primary practice location

25321 Railroad Canyon Rd
Suite 503
Lake Elsinore, CA 92532-2702

Mailing address

25321 Railroad Canyon Road
Suite 503
Lake Elsinore, CA 92532-2702
Phone (951) 244-1122

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
I20090827000691 CA Practitioner - Optometry 8628123668 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11411TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
A.M. Palanca-Capistrano,M.D. Inc. CurrentSince Mar 31, 2016 Accepting new patients
Michelle Cruz OD Inc Optometrist CurrentSince Jan 26, 2025 Accepting new patients

Locations

720 Magnolia Ave
Ste A4
Corona, CA 92879
Phone (951) 372-9227

25321 Railroad Canyon Rd
Ste 503
Lake Elsinore, CA 92532
Phone (951) 244-1122

Organizations & group practices 2

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": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303171200000",
    "number": "1740495183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25321 RAILROAD CANYON ROAD",
            "address_2": "SUITE 503",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925322702",
            "telephone_number": "951-244-1122",
            "fax_number": "951-244-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25321 RAILROAD CANYON RD",
            "address_2": "SUITE 503",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925322702",
            "telephone_number": "951-244-1122",
            "fax_number": "951-244-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUU",
        "first_name": "THI",
        "middle_name": "DONG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2011-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11411T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elsinore, CA

Sources for this page

Verify at the official NPI Registry.