Individual provider Active NPI

Audrey Chu, OD

  • Optometrist
  • Los Altos, CA
National Provider Identifier
1770005183
Registry record updated Jul 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
33720 Issued in CA
Practice address
286 State St
Los Altos, CA 94022-2813
Phone
(650) 948-6910
NPI assigned
Jul 7, 2017
Last updated
Jul 7, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 33720 CA Primary

Addresses

Primary practice location

286 State St
Los Altos, CA 94022-2813

Mailing address

1219 Thurston Ave
Los Altos, CA 94024-6865
Phone (650) 823-3588

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
I20180118002719 CA Practitioner - Optometry 4183983117 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33720CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Lite Optometry, Inc. Optometrist CurrentSince Dec 18, 2017 Accepting new patients

Locations

286 State St
Los Altos, CA 94022
Phone (650) 948-6910

Organizations & group practices 1

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": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499385600000",
    "number": "1770005183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 THURSTON AVE",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940246865",
            "telephone_number": "16508233588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 STATE ST",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940222813",
            "telephone_number": "650-948-6910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHU",
        "first_name": "AUDREY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-07",
        "last_updated": "2017-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Altos, CA

Sources for this page

Verify at the official NPI Registry.