Individual provider Active NPI

Grace Tseng, O.D.

  • Optometrist
  • Berkeley, CA
National Provider Identifier
1780208330
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34634 Issued in CA
Practice address
200 Minor Hall University of California at Berkeley
Berkeley, CA 94720-0001
Phone
(510) 642-0945
NPI assigned
May 29, 2020
Last updated
Aug 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CA
Optometrist 152W00000X 34634 CA Primary

Addresses

Primary practice location

200 Minor Hall University of California at Berkeley
Berkeley, CA 94720-0001

Mailing address

2330 Warring St Apt 122
Berkeley, CA 94704-1803
Phone (702) 209-1476

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
I20201201002362 CA Practitioner - Optometry 6204247968 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mendelson and Mark Optometric CorporationGroup PAC ID 0244607562, 8 clinicians

Practice addresses (Care Compare)

1010 W Fremont Ave
Suite 200
Sunnyvale, CA 94087-3019
Phone 4087396200120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Amplify Physicians of California PC Optometrist CurrentSince Jul 1, 2024 Accepting new patients
Silicon Valley Eye Physicians CurrentSince Sep 1, 2021 Accepting new patients
Amplify Physicians of California PC CurrentSince Jul 1, 2024 Accepting new patients
Mendelson & Mark Optometric Corporation Optometrist CurrentSince Sep 1, 2022 Accepting new patients

Locations

1010 W Fremont Ave
Sunnyvale, CA 94087
Phone (408) 739-6200

1010 W Fremont Ave
Ste 200
Sunnyvale, CA 94087
Phone (408) 739-6200

1010 W Fremont Ave
Ste 400
Sunnyvale, CA 94087

Organizations & group practices 4

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": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1780208330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 WARRING ST APT 122",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041803",
            "telephone_number": "702-209-1476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MINOR HALL UNIVERSITY OF CALIFORNIA AT BERKELEY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947200001",
            "telephone_number": "510-642-0945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSENG",
        "first_name": "GRACE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-29",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.