Individual provider Active NPI

Jenny Kuan, O.D.

  • Optometrist
  • Santa Fe Springs, CA
National Provider Identifier
1891925640
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13767 Issued in CA
Practice address
12400 Bloomfield Ave
Santa Fe Springs, CA 90670-4750
Phone
(562) 967-2820
NPI assigned
Jul 15, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13767 CA Primary

Addresses

Primary practice location

12400 Bloomfield Ave
Santa Fe Springs, CA 90670-4750

Mailing address

12400 Bloomfield Ave
Santa Fe Springs, CA 90670-4750
Phone (562) 967-2820

Other practice location 1

5080 E Montclair Plaza Ln
Montclair, CA 91763-1520
Phone (909) 625-6986

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20130522000084 CA Practitioner - Optometry 1456599026 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

1255 W Arrow Hwy
San Dimas, CA 91773-2340
Phone (909) 394-2526

Merit-based Incentive Payment System (MIPS)

Final score
78.61 of 100Reported as group
Quality
58.7
Improvement activities
40
Cost
75.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13767CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pih Health Physicians CurrentSince Jul 1, 2017 Accepting new patients
Pih Health Physicians CurrentSince Jul 1, 2017 Accepting new patients
Southern California Permanente Medical Group CurrentSince Apr 17, 2023 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
O.C. Optometric Group Inc. Optometrist CurrentSince Mar 15, 2013 Accepting new patients
Southern California Permanente Medical Group CurrentSince Apr 17, 2023 Accepting new patients
Pih Health Physicians Current Accepting new patients
Luxottica of America Inc Past Accepting new patients

Locations

10502 Katella Ave
Anaheim, CA 92804
Phone (714) 776-2020

1011 Baldwin Park Blvd
Baldwin Park, CA 91706
Phone (626) 851-1011

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3340

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

12400 Bloomfield Ave
Santa Fe Springs, CA 90670
Phone (562) 789-5434

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jennykuan@pihh.allscriptsdirect.net

Organizations & group practices 8

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": "1247616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1891925640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12400 BLOOMFIELD AVE",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906704750",
            "telephone_number": "562-967-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12400 BLOOMFIELD AVE",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906704750",
            "telephone_number": "562-967-2820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5080 E Montclair Plaza Ln",
            "address_purpose": "LOCATION",
            "city": "Montclair",
            "state": "CA",
            "postal_code": "917631520",
            "country_code": "US",
            "telephone_number": "909-625-6986",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUAN",
        "first_name": "JENNY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-15",
        "last_updated": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1011 Baldwin Park Blvd",
            "city": "Baldwin Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917065806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Fe Springs, CA

Sources for this page

Verify at the official NPI Registry.