Individual provider Active NPI

Susan Park Tseng, OD

  • Optometrist
  • Chicago, IL
National Provider Identifier
1750581328
Registry record updated Mar 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.009987 Issued in IL
Practice address
9928 S Western Ave
Chicago, IL 60643-1831
Phone
(773) 303-8279
NPI assigned
Jul 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 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 046.009987 IL Primary

Addresses

Primary practice location

9928 S Western Ave
Chicago, IL 60643-1831

Mailing address

9928 S Western Ave
Chicago, IL 60643-1831
Phone (773) 303-8279

Other identifiers 1

IdentifierTypeStateIssuer
046009987MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.009987ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visionworks, Inc Past Accepting new patients
Eric Tseng O.D., Prof. Corp. Optometrist Past Accepting new patients
Visionworks, Inc. Optometrist PastSince Mar 17, 2018 Accepting new patients

Organizations & group practices 3

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": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394409600000",
    "number": "1750581328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9928 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431831",
            "telephone_number": "773-303-8279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9928 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431831",
            "telephone_number": "773-303-8279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSENG",
        "first_name": "SUSAN",
        "middle_name": "PARK",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2014-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.009987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009987",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.