Individual provider Active NPI

Richard J. Chong, OD

  • Optometrist
  • San Francisco, CA
National Provider Identifier
1780679431
Registry record updated Sep 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6632T Issued in CA
Practice address
1833 Powell St
San Francisco, CA 94133-2838
Phone
(415) 362-2000
Fax
(415) 362-7520
NPI assigned
Sep 19, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6632T CA Primary

Addresses

Primary practice location

1833 Powell St
San Francisco, CA 94133-2838

Mailing address

1833 Powell St
San Francisco, CA 94133-2838
Phone (415) 362-2000

Other identifiers 1

IdentifierTypeStateIssuer
SD0066320MedicaidCA

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
I20081120000522 CA Practitioner - Optometry 2769542752 Practice locations: San Francisco, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1833 Powell St
San Francisco, CA 94133-2838
Phone (415) 362-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6632TCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283817600000",
    "number": "1780679431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1833 POWELL ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941332838",
            "telephone_number": "415-362-2000",
            "fax_number": "415-362-7520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1833 POWELL ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941332838",
            "telephone_number": "415-362-2000",
            "fax_number": "415-362-7520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHONG",
        "first_name": "RICHARD",
        "middle_name": "J.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2010-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6632T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0066320",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.