Individual provider Active NPI

Eric Sooyong Ahn, MD

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1841457652
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X
License
151227 Issued in CA
Practice address
420 E 3Rd St Ste 603
Los Angeles, CA 90013-1645
Phone
(213) 680-1551
Fax
(213) 680-2148
NPI assigned
May 20, 2008
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 0101258022 VA
Ophthalmology Physician 207W00000X D0074509 MD
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X 151227 CA Primary

Addresses

Primary practice location

420 E 3Rd St Ste 603
Los Angeles, CA 90013-1645

Mailing address

420 E 3Rd St Ste 603
Los Angeles, CA 90013-1645
Phone (213) 680-1551

Other identifiers 2

IdentifierTypeStateIssuer
MD160059OtherORMEDICAL LICENSE
151227OtherCAMEDICAL LICENSE

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170912002452 CA Practitioner - Ophthalmology 2668610882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Albany Medical College of Union University, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

879 W 190TH St
Suite 100
Gardena, CA 90248-4223
Phone (310) 329-9975

Merit-based Incentive Payment System (MIPS)

Final score
84.43 of 100Reported as group
Quality
91.88
Promoting interoperability
76
Improvement activities
40
Cost
76.22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0074509MDMDOphthalmology Physician
0101258022VAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East-West Eye Institute a Medical Corporation Ophthalmology CurrentSince Oct 1, 2017 Accepting new patients
East-West Eye Institute a Medical Corporation Ophthalmology CurrentSince Oct 1, 2017 Accepting new patients
East-West Eye Institute a Medical Corporation Ophthalmology Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients
East-West Eye Institute a Medical Corporation Ophthalmology Past Accepting new patients
Little Company of Mary Affiliated Services Inc Past Accepting new patients
Inova Health Care Services Past Accepting new patients
Skypark Surgery Center LLC PastSince Sep 30, 2021 Accepting new patients

Locations

75 Enterprise
Ste 200
Aliso Viejo, CA 92656
Phone (949) 554-4688

475 W Badillo St
Covina, CA 91723
Phone (626) 331-2209

1045 W Redondo Beach Blvd
Ste 400
Gardena, CA 90247
Phone (310) 219-7701

1300 W 155th St
Ste 104
Gardena, CA 90247
Phone (310) 329-9975

879 W 190th St
Ste 100
Gardena, CA 90248
Phone (310) 329-9115

420 E 3rd St
Ste 603
Los Angeles, CA 90013
Phone (213) 625-2694

50 Alessandro Pl
Ste 150
Pasadena, CA 91105
Phone (626) 577-5437

571 W 7th St
San Pedro, CA 90731
Phone (310) 831-1201

23441 Madison St
Ste 120
Torrance, CA 90505
Phone (310) 370-3628

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/amanpreet

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1841457652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E 3RD ST STE 603",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900131645",
            "telephone_number": "213-680-1551",
            "fax_number": "213-680-2148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E 3RD ST STE 603",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900131645",
            "telephone_number": "213-680-1551",
            "fax_number": "213-680-2148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHN",
        "first_name": "ERIC",
        "middle_name": "SOOYONG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101258022",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D0074509",
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "151227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MD160059",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "151227",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.