NPIMap

Organization Active NPI

Wyse Willa Optometry, Inc.

Doing business as Hollywood Vermont Optometrics

  • Optometrist
  • Pasadena, CA
National Provider Identifier
1770203283
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
WYSE WILLA OPTOMETRY, INC.
Doing business as
Hollywood Vermont Optometrics
Walnut Hill Pasadena Optometrics
Practice address
1368 E Walnut St
Pasadena, CA 91106-1528
Phone
(626) 796-3105
Fax
(626) 796-8816
NPI assigned
Sep 2, 2022
Last updated
Sep 2, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
WYSE WILLA OPTOMETRY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Authorized official

Name
Dr. Wendy Shem Yeh, OD
Title
Owner
Phone
(626) 796-3105

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary
Corneal and Contact Management Optometrist 152WC0802X NU
Pediatric Optometrist 152WP0200X NU
Sports Vision Optometrist 152WS0006X NU
Vision Therapy Optometrist 152WV0400X NU

Addresses

Primary practice location

1368 E Walnut St
Pasadena, CA 91106-1528

Mailing address

1368 E Walnut St
Pasadena, CA 91106-1528
Phone (626) 796-3105

Other practice location 1

1609 N Vermont Ave
Los Angeles, CA 90027-5312
Phone (323) 663-8346

Other names 2

  • Hollywood Vermont Optometrics Doing business as
  • Walnut Hill Pasadena Optometrics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231018000249 CA Part B Supplier - Clinic/Group Practice 3072968577 Receives reassigned benefits from 5 practitioners
2 other NPIs on this enrollment
Practice locations: Los Angeles, CA; Pasadena, CA; Arcadia, CA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Wyse Willa Optometry Inc3 organizations share this tax ID, including this one
Part of
Wyse Willa Optometry Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1368 E Walnut St
Pasadena, CA 91106
Phone (626) 796-3105

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 5

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": "1662076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662076800000",
    "number": "1770203283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1368 E WALNUT ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911061528",
            "telephone_number": "626-796-3105",
            "fax_number": "626-796-8816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1368 E WALNUT ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911061528",
            "telephone_number": "626-796-3105",
            "fax_number": "626-796-8816"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1609 N Vermont Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900275312",
            "country_code": "US",
            "telephone_number": "323-663-8346",
            "fax_number": "323-663-2316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WYSE WILLA OPTOMETRY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WYSE WILLA OPTOMETRY, INC.",
        "enumeration_date": "2022-09-02",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A",
        "authorized_official_last_name": "SHEM YEH",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-796-3105",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hollywood Vermont Optometrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Walnut Hill Pasadena Optometrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; 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.