Individual provider Active NPI

Odette Yang, O.D.

  • Optometrist
  • Merced, CA
National Provider Identifier
1922103001
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10678T Issued in CA
Practice address
3371 G St
Suite a
Merced, CA 95340-0964
Phone
(209) 723-3103
NPI assigned
Sep 14, 2006
Sex
Female
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 10678T CA Primary

Addresses

Primary practice location

3371 G St
Suite a
Merced, CA 95340-0964

Mailing address

3371 G St
Suite a
Merced, CA 95340-0964

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
I20070226000806 CA Practitioner - Optometry 3870695513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gateway Optometric CenterGroup PAC ID 3375645716, 2 clinicians

Practice addresses (Care Compare)

3371 G St
Suite a
Merced, CA 95340-0990
Phone (209) 723-3103

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10678TCAMDOptometrist
10678CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Optometric Center Optometrist CurrentSince Aug 1, 2006 Accepting new patients

Locations

3371 G St
Ste A
Merced, CA 95340
Phone (209) 723-3103

Organizations & group practices 1

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922103001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3371 G ST",
            "address_2": "SUITE A",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953400964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3371 G ST",
            "address_2": "SUITE A",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953400964",
            "telephone_number": "209-723-3103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "ODETTE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10678T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

Verify at the official NPI Registry.