Individual provider Active NPI

Amy Thien Huong Tse, OD

  • Optometrist
  • Fullerton, CA
National Provider Identifier
1821684028
Registry record updated Dec 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34735 Issued in CA
Practice address
101 Laguna Rd Ste C
Fullerton, CA 92835-3637
Phone
(714) 888-2080
NPI assigned
Dec 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34735 CA Primary

Addresses

Primary practice location

101 Laguna Rd Ste C
Fullerton, CA 92835-3637

Mailing address

18424 Santana Ave
Cerritos, CA 90703-8038
Phone (714) 566-5363

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
I20210315000328 CA Practitioner - Optometry 6305252503 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34735CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lakewood Eye Physicians and Surgeons Inc a Medical Group Optometrist CurrentSince Mar 3, 2024 Accepting new patients
Lakewood Eye Physicians and Surgeons Inc a Medical Group Optometrist CurrentSince Mar 3, 2024 Accepting new patients

Locations

3300 E South St
Ste 105
Lakewood, CA 90805
Phone (562) 232-1442

3801 Katella Ave
Ste 130
Los Alamitos, CA 90720
Phone (562) 430-3561

Organizations & group practices 2

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": "1607731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607731200000",
    "number": "1821684028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18424 SANTANA AVE",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907038038",
            "telephone_number": "714-566-5363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 LAGUNA RD STE C",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353637",
            "telephone_number": "714-888-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSE",
        "first_name": "AMY",
        "middle_name": "THIEN HUONG",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-12",
        "last_updated": "2020-12-12",
        "certification_date": "2020-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.