Active NPI
Susy Balla Vrouvas, O.D.
- Optometrist
- San Francisco, CA
National Provider Identifier
1811044027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 7411T
- Practice address
- 1635 Divisadero St
San Francisco, CA 94115-3036 - Phone
- (415) 833-3939
- Fax
- (415) 833-2609
- NPI assigned
- Jan 3, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 7411T | CA | Primary |
Addresses
Primary practice location
1635 Divisadero St
San Francisco, CA 94115-3036
Mailing address
1635 Divisadero St
San Francisco, CA 94115-3036
Phone (415) 833-3939
Other names 1
- Dr. Susy Balla
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7411T | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641859200000",
"number": "1811044027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1635 DIVISADERO ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941153036",
"telephone_number": "415-833-3939",
"fax_number": "415-833-2609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1635 DIVISADERO ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941153036",
"telephone_number": "415-833-3939",
"fax_number": "415-833-2609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VROUVAS",
"first_name": "SUSY",
"middle_name": "BALLA",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-03",
"last_updated": "2022-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "7411T",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "The Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "1635 Divisadero St",
"city": "San Francisco",
"state": "CA",
"country_code": "US",
"postal_code": "941153036",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "SUSY",
"last_name": "BALLA",
"prefix": "DR.",
"credential": "O.D.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.