Organization Active NPI

Selena Fu, MD, LLC

  • Ophthalmology Physician
  • Overland Park, KS
National Provider Identifier
1891328720
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
SELENA FU, MD, LLC
Practice address
10500 Quivira Rd
Overland Park, KS 66215-2306
Phone
(917) 623-5442
NPI assigned
Feb 19, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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

Authorized official

Name
Dr. Selena Fu, MDNPI 1730296963
Title
President
Phone
(917) 623-5442

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary
Ophthalmic Plastic and Reconstructive Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207WX0200X

Addresses

Primary practice location

10500 Quivira Rd
Overland Park, KS 66215-2306

Mailing address

3147 W 145TH Ter
Leawood, KS 66224-3755
Phone (917) 623-5442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200403000746 KS Part B Supplier - Clinic/Group Practice 4789013236 Receives reassigned benefits from 1 practitioner
Practice locations: Overland Park, KS

National Provider Directory

National Provider Directory

Locations

13300 Metcalf Ave
Overland Park, KS 66213
Phone (913) 387-1104

10620 W 87th St
Overland Park, KS 66214
Phone (913) 549-4855

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582070400000",
    "number": "1891328720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3147 W 145TH TER",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662243755",
            "telephone_number": "917-623-5442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10500 QUIVIRA RD",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662152306",
            "telephone_number": "917-623-5442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELENA FU, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-19",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A",
        "authorized_official_last_name": "FU",
        "authorized_official_first_name": "SELENA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-623-5442",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.