Individual provider Active NPI

Lynn Kato Matsuda, OD FAAO

  • Corneal and Contact Management Optometrist
  • Los Angeles, CA
National Provider Identifier
1811961402
Registry record updated Dec 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
9488T Issued in CA
Practice address
250 East 1St St
Suite 802
Los Angeles, CA 90012-3875
Phone
(213) 628-7419
Fax
(213) 620-9110
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 9488T CA Primary

Addresses

Primary practice location

250 East 1St St
Suite 802
Los Angeles, CA 90012-3875

Mailing address

250 East 1St St
Suite 802
Los Angeles, CA 90012-3875
Phone (213) 628-7419

Other identifiers 1

IdentifierTypeStateIssuer
WOP9488BOtherCAPTAN

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
I20110831000719 CA Practitioner - Optometry 3274703129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Vision PCGroup PAC ID 9234472242, 115 clinicians

Practice addresses (Care Compare)

12461 W Washington Blvd
Los Angeles, CA 90066-5511
Phone (310) 390-6287

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9488CAMDProfessional Counselor
9488TCAMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Total Vision PC CurrentSince Feb 1, 2022 Accepting new patients
Charles J Korth OD, Inc PastSince Jan 7, 2014 Accepting new patients
Marina Eyecare Center Past Accepting new patients
Steven T Klein OD & Kimberly Plattner OD a Professional Corporation Past Accepting new patients

Locations

334B E 2nd St
Los Angeles, CA 90012
Phone (213) 628-7419

12461 W Washington Blvd
Los Angeles, CA 90066
Phone (310) 390-6287

27271 Las Ramblas
Ste 210
Mission Viejo, CA 92691

1 W California Blvd
Ste 513
Pasadena, CA 91105
Phone (626) 382-2509

11717 Bernardo Plaza Ct
Ste 105
San Diego, CA 92128
Phone (858) 487-5555

530 Bush St
Ste 101
San Francisco, CA 94108
Phone (415) 291-8560

Interoperability endpoints

  • Direct secure messaging: lynn.matsuda@uprisedirect.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260489600000",
    "number": "1811961402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 EAST 1ST ST",
            "address_2": "SUITE 802",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900123875",
            "telephone_number": "213-628-7419",
            "fax_number": "213-620-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 EAST 1ST ST",
            "address_2": "SUITE 802",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900123875",
            "telephone_number": "213-628-7419",
            "fax_number": "213-620-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSUDA",
        "first_name": "LYNN",
        "middle_name": "KATO",
        "name_prefix": "Dr.",
        "credential": "OD FAAO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2009-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "9488T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "WOP9488B",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.