Individual provider Active NPI

Yifan Lu

  • Ophthalmology Physician
  • Boston, MA
National Provider Identifier
1861028805
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
1018626 Issued in MA
Practice address
243 Charles St
Boston, MA 02114-3096
Phone
(617) 573-3288
Fax
(617) 573-3698
NPI assigned
Mar 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 1018626 MA Primary

Addresses

Primary practice location

243 Charles St
Boston, MA 02114-3096

Mailing address

1493 Cambridge St
Cambridge, MA 02139-1047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240625002982 MA Practitioner - Ophthalmology 5395167753
I20250804002679 CA Practitioner - Ophthalmology 5395167753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Harvard Medical School, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kent W Small MD a Medical CorporationGroup PAC ID 8325001415, 2 clinicians

Practice addresses (Care Compare)

411 N Central Ave
Suite 115
Glendale, CA 91203-3138
Phone (818) 552-5040

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kent W Small, MD a Medical Corporation Ophthalmology CurrentSince Aug 1, 2025 Accepting new patients

Locations

411 N Central Ave
Ste 115
Glendale, CA 91203
Phone (818) 552-5040

8635 W 3rd St
Ste 395W
Los Angeles, CA 90048
Phone (310) 659-2200

Interoperability endpoints

  • Direct secure messaging: yifanlumd@macularetinainstitute.direct.eyemdemr.com
  • Direct secure messaging: ylu371155@direct.bilh.masshiway.net

Organizations & group practices 1

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": "1584835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1861028805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1493 CAMBRIDGE ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021391047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 CHARLES ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143096",
            "telephone_number": "617-573-3288",
            "fax_number": "617-573-3698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LU",
        "first_name": "YIFAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-22",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "1018626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.