Individual provider Active NPI

Mengli Han, O.D.

  • Optometrist
  • Berkeley, CA
National Provider Identifier
1861946576
Registry record updated Aug 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
33433 Issued in CA
Practice address
230 Minor Hall
Berkeley, CA 94720
Phone
(510) 642-2020
NPI assigned
Aug 10, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 33433 CA Primary

Addresses

Primary practice location

230 Minor Hall
Berkeley, CA 94720

Mailing address

200 Minor Hall
Berkeley, CA 94702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20180426001713 MA Practitioner - Optometry 5991091407 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices
McPhs UniversityGroup PAC ID 2365682713, 19 clinicians

Practice addresses (Care Compare)

10 Lincoln SQ
Worcester, MA 01608-1135
Phone (508) 373-5830

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5250MAMDMental Health Counselor
33433CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Edward M. Kennedy Community Health Center, Inc CurrentSince Apr 1, 2019 Accepting new patients
McPhs University Optometrist CurrentSince Mar 25, 2018 Accepting new patients
Edward M. Kennedy Community Health Center, Inc CurrentSince Apr 1, 2019 Accepting new patients
Leominster Family Eyecare PLLC Optometrist PastSince Mar 25, 2018 Accepting new patients
Edward M. Kennedy Community Health Center, Inc Past Accepting new patients

Locations

354 Waverley St
Framingham, MA 01702
Phone (508) 270-5700

41 Cape Rd
Milford, MA 01757
Phone (508) 270-5750

10 Lincoln Sq
Worcester, MA 01608
Phone (508) 373-5607

605 Lincoln St
Worcester, MA 01605
Phone (508) 856-0104

10 Lincoln Sq
Rm 112G
Worcester, MA 01608

19 Tacoma St
Worcester, MA 01605
Phone (508) 854-2122

650 Lincoln St
Worcester, MA 01605
Phone (508) 532-7318

Organizations & group practices 5

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": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470787200000",
    "number": "1861946576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MINOR HALL",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 MINOR HALL",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94720",
            "telephone_number": "510-642-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "MENGLI",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-10",
        "last_updated": "2016-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.