Organization Active NPI

Huntington Beach Optometry, Apc

Doing business as Huntington Beach Optometry

  • Optometrist
  • Huntington Beach, CA
National Provider Identifier
1760583074
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
COR 960 Issued in CA
Legal business name
HUNTINGTON BEACH OPTOMETRY, APC
Doing business as
Huntington Beach Optometry
Practice address
5890 Edinger Ave
Huntington Beach, CA 92649-1705
Phone
(714) 840-2020
Fax
(714) 840-2025
NPI assigned
Sep 26, 2006
Last updated
Sep 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Authorized official

Name
Dr. Shilah Ann Tsai, O.D.NPI 1265406912
Title
Vice President
Phone
(714) 840-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X COR 960 CA Primary

Addresses

Primary practice location

5890 Edinger Ave
Huntington Beach, CA 92649-1705

Mailing address

5890 Edinger Ave
Huntington Beach, CA 92649-1705
Phone (714) 840-2020

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ09926ZOtherCABLUE SHIELD GROUP PPIN

Other names 1

  • Huntington Beach Optometry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040908001521 CA Part B Supplier - Clinic/Group Practice 7315913589 Receives reassigned benefits from 1 practitioner
Practice locations: Huntington Beach, CA

National Provider Directory

National Provider Directory

Locations

5842 Edinger Ave
Huntington Beach, CA 92649
Phone (714) 840-2020

5890 Edinger Ave
Huntington Beach, CA 92649
Phone (714) 840-2020

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725321600000",
    "number": "1760583074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5890 EDINGER AVE",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926491705",
            "telephone_number": "714-840-2020",
            "fax_number": "714-840-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5890 EDINGER AVE",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926491705",
            "telephone_number": "714-840-2020",
            "fax_number": "714-840-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUNTINGTON BEACH OPTOMETRY, APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A",
        "authorized_official_last_name": "TSAI",
        "authorized_official_first_name": "SHILAH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "714-840-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "COR 960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP PPIN",
            "identifier": "ZZZ09926Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Huntington Beach Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.