Nicole J NA, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

14934 Issued in CA

Practice address

3250 W Olympic Blvd Ste 221
Los Angeles, CA 90006-2368

Phone

(323) 766-9000

NPI assigned

Jun 17, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Southern California College of Optometry, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bethel Eye Center Medical Corporation

  • Ophthalmology Physician
  • Los Angeles, CA
  • NPI 1972980191
  Medicare reassignment NPD
• Golden Ardaya & Lin Optometry Inc

  • Optometrist
  • Whittier, CA
  • NPI 1962764340
  Medicare reassignment
• Italee Optometric Center, Inc.

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1326357922
  NPD (past)
• Luxi Optometry, Inc

  • Ophthalmology Physician
  • Los Angeles, CA
  • NPI 1770048266
  NPD (past)

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1922412063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 S WESTERN AVE",
            "address_2": "STE 229",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900061084",
            "telephone_number": "213-385-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 W OLYMPIC BLVD STE 221",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062368",
            "telephone_number": "323-766-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NA",
        "first_name": "NICOLE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-17",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claire Eun NA
• Eun Shin NA
• Hannah NA
• Kyoung Joo NA
• Michelle M NA
• Rosa NA, D.C., L.AC.
• Sharon Yehjin NA
• Soon Kyong NA, L.AC.
• Young M NA, AC
• Reem Naamani, RDN

• Optometrist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.