Individual provider Active NPI

Htoo Htoo Lu, OD

  • Optometrist
  • Petaluma, CA
National Provider Identifier
1811547656
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34361-TLG Issued in CA
Practice address
855 Lakeville St Ste 102
Petaluma, CA 94952-7328
Phone
(510) 557-8486
NPI assigned
Sep 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34361-TLG CA Primary

Addresses

Primary practice location

855 Lakeville St Ste 102
Petaluma, CA 94952-7328

Mailing address

37036 Alexander St
Fremont, CA 94536-6502
Phone (510) 557-8486

Other practice location 1

162 W D St
Lemoore, CA 93245-2938
Phone (559) 924-4417

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
I20191212002168 CA Practitioner - Optometry 5799118378 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Western University of Health Sciences College of Dental Med, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

855 Lakeville St
Suite 102
Petaluma, CA 94952-7328
Phone (707) 763-1423

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34361-TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Htoo Htoo Lu OD Prof Corp Optometrist CurrentSince Aug 6, 2025 Accepting new patients
Gerald T Pittler O. D. Inc. Optometrist CurrentSince Jul 9, 2025 Accepting new patients

Locations

855 Lakeville St
Ste 102
Petaluma, CA 94952
Phone (707) 763-1423

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1811547656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37036 ALEXANDER ST",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945366502",
            "telephone_number": "510-557-8486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 LAKEVILLE ST STE 102",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949527328",
            "telephone_number": "510-557-8486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "162 W D St",
            "address_purpose": "LOCATION",
            "city": "Lemoore",
            "state": "CA",
            "postal_code": "932452938",
            "country_code": "US",
            "telephone_number": "559-924-4417",
            "fax_number": "559-924-3942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LU",
        "first_name": "HTOO HTOO",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-13",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34361-TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

Verify at the official NPI Registry.