Individual provider Active NPI

Julia Shao

  • Optometrist
  • San Francisco, CA
National Provider Identifier
1881276129
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT35177 Issued in CA
Practice address
2574 San Bruno Ave
San Francisco, CA 94134-1505
Phone
(415) 391-9686
NPI assigned
Apr 26, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT35177 CA Primary

Addresses

Primary practice location

2574 San Bruno Ave
San Francisco, CA 94134-1505

Mailing address

2574 San Bruno Ave
San Francisco, CA 94134-1505

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
I20230607003289 CA Practitioner - Optometry 5193182053 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT35177CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
North East Medical Services CurrentSince Jul 1, 2023 Accepting new patients
North East Medical Services CurrentSince Jul 1, 2023 Accepting new patients

Locations

211 Eastmoor Ave
Daly City, CA 94015
Phone (650) 550-3923

2574 San Bruno Ave
San Francisco, CA 94134
Phone (415) 352-5090

82 Leland Ave
San Francisco, CA 94134
Phone (415) 391-9688

1520 Stockton St
San Francisco, CA 94133

1870 Lundy Ave
San Jose, CA 95131
Phone (408) 573-9686

Interoperability endpoints

  • Direct secure messaging: jshao19106@northeastmedicalservicesnems.direct-ci.com

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": "1619395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1881276129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2574 SAN BRUNO AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941341505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2574 SAN BRUNO AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941341505",
            "telephone_number": "415-391-9686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAO",
        "first_name": "JULIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-26",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT35177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.