Individual provider Active NPI

Noelle Sung, O.D.

  • Optometrist
  • San Jose, CA
National Provider Identifier
1851444533
Registry record updated Jan 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T12861 Issued in CA
Practice address
1172 Lincoln Ave
San Jose, CA 95125-3001
Phone
(408) 283-7100
NPI assigned
Jan 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T12861 CA Primary

Addresses

Primary practice location

1172 Lincoln Ave
San Jose, CA 95125-3001

Mailing address

1172 Lincoln Ave
San Jose, CA 95125-3001
Phone (408) 283-7100

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
I20060111000542 CA Practitioner - Optometry 4284657602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Trainor and Ngan Professional Optometric CorporationGroup PAC ID 0042300808, 2 clinicians

Practice addresses (Care Compare)

1172 Lincoln Ave
San Jose, CA 95125-3001
Phone (408) 283-7100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12861CAMDMental Health Counselor
T12861CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Trainor & Ngan Professional Optometric Corporation Optometrist CurrentSince Aug 5, 2011 Accepting new patients
Visual Eyes Optometrist PastSince Aug 5, 2011 Accepting new patients

Locations

1172 Lincoln Ave
San Jose, CA 95125
Phone (408) 283-7100

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483401600000",
    "number": "1851444533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1172 LINCOLN AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951253001",
            "telephone_number": "408-283-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1172 LINCOLN AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951253001",
            "telephone_number": "408-283-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNG",
        "first_name": "NOELLE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2017-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "T12861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.