Individual provider Active NPI

Rodney Merritt Lum, O.D.

  • Optometrist
  • Campbell, CA
National Provider Identifier
1912045246
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9300T Issued in CA
Practice address
621 E Campbell Ave
Suite 11-B
Campbell, CA 95008-2139
Phone
(408) 378-4661
NPI assigned
Feb 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9300T CA Primary

Addresses

Primary practice location

621 E Campbell Ave
Suite 11-B
Campbell, CA 95008-2139

Mailing address

439 Kentmere CT
Mountain View, CA 94040-3272
Phone (650) 965-8694

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
I20101006000431 CA Practitioner - Optometry 2567654726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Vision PCGroup PAC ID 9234472242, 115 clinicians

Practice addresses (Care Compare)

338 E Hamilton Ave
Campbell, CA 95008-0207
Phone (408) 866-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9300TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Total Vision PC Optometrist CurrentSince Sep 1, 2021 Accepting new patients
Arthur W Low OD & Rodney M Lum OD PTRS Optometrist PastSince Dec 11, 2010 Accepting new patients
J Pietrantonio OD Inc Optometrist PastSince Jan 1, 2005 Accepting new patients

Locations

338 E Hamilton Ave
Campbell, CA 95008
Phone (408) 866-2020

233 N Santa Cruz Ave
Los Gatos, CA 95030
Phone (408) 354-9310

27271 Las Ramblas
Ste 210
Mission Viejo, CA 92691

3021 Meridian Ave
San Jose, CA 95124
Phone (408) 979-1928

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912045246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "439 KENTMERE CT",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940403272",
            "telephone_number": "650-965-8694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 E CAMPBELL AVE",
            "address_2": "SUITE 11-B",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950082139",
            "telephone_number": "408-378-4661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUM",
        "first_name": "RODNEY",
        "middle_name": "MERRITT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9300T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

Verify at the official NPI Registry.