Individual provider Active NPI

Jessica Liaw, OD

  • Optometrist
  • Anaheim, CA
National Provider Identifier
1932827342
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
35183 Issued in CA
Practice address
5460 E la Palma Ave
Anaheim, CA 92807-2023
Phone
(714) 463-7500
NPI assigned
Aug 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 35183 CA
Optometrist 152W00000X 35183 CA Primary

Addresses

Primary practice location

5460 E la Palma Ave
Anaheim, CA 92807-2023

Mailing address

PO Box 17444
Anaheim, CA 92817-7444
Phone (425) 246-5818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20230920002562 WA Practitioner - Optometry 2961887963 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Washington Professional PCGroup PAC ID 3476927997, 61 clinicians

Practice addresses (Care Compare)

1468 158TH PL NE
Bellevue, WA 98008-2782
Phone (425) 883-9300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35183CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jason a Sifrit & Associates Corneal and Contact Management CurrentSince Jul 25, 2023 Accepting new patients
Aeg Washington Professional PC Optometrist CurrentSince Aug 18, 2024 Accepting new patients
Dr. Sam Hsu & Associates, P.S Optometrist PastSince Aug 18, 2024 Accepting new patients

Locations

1468 158th Pl NE
Bellevue, WA 98008
Phone (425) 883-9300

12310 NE 8th St
Ste 101
Bellevue, WA 98005
Phone (425) 455-0001

1098 Alder Ave
Marysville, WA 98270
Phone (360) 659-6255

2914 E Madison St
Ste 109
Seattle, WA 98112
Phone (206) 333-0564

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1932827342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17444",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928177444",
            "telephone_number": "425-246-5818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5460 E LA PALMA AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928072023",
            "telephone_number": "714-463-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIAW",
        "first_name": "JESSICA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "35183",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.