Alishia Chan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT13810 Issued in CA

Practice address

3417 Broadway St Ste J3
American Cyn, CA 94503-1262

Phone

(707) 553-6020

Fax

(707) 643-2024

NPI assigned

Jul 28, 2009

Last updated

Jul 20, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

New England College of Optometry, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• 20/20 Eye Wellness Optometry, Inc.

  • Optometrist
  • Pleasanton, CA
  • NPI 1215274717
  Medicare reassignment Authorized official
• Peninsula Eye Physicians Medical Group,Inc.

  • Ophthalmology Physician
  • San Mateo, CA
  • NPI 1346255064
  NPD (past)

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342742400000",
    "number": "1932330750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 BROADWAY ST STE J3",
            "city": "AMERICAN CYN",
            "state": "CA",
            "postal_code": "945031262",
            "telephone_number": "707-553-6020",
            "fax_number": "707-643-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 BROADWAY ST STE J3",
            "city": "AMERICAN CYN",
            "state": "CA",
            "postal_code": "945031262",
            "telephone_number": "707-553-6020",
            "fax_number": "707-643-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "ALISHIA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-28",
        "last_updated": "2012-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT13810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXID OF ANOTHER PRACTICE",
            "identifier": "1346255064",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Medbridge Pro Care, LLC

• Optometrist in American Cyn, CA
• Providers in American Cyn, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; 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.