Individual provider Active NPI

Michael Shun Nun Ip, MD

  • Ophthalmology Physician
  • Pasadena, CA
National Provider Identifier
1982670402
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G141944 Issued in CA
Practice address
625 S Fair Oaks Ave Ste 280
Pasadena, CA 91105-2670
Phone
(626) 817-4747
Fax
(626) 817-4748
NPI assigned
Feb 24, 2006
Last updated
Jan 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G141944 CA Primary

Addresses

Primary practice location

625 S Fair Oaks Ave Ste 280
Pasadena, CA 91105-2670

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160526002213 CA Practitioner - Ophthalmology 7810077203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
New York University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

150 N Orange Grove Blvd
Pasadena, CA 91103-3534
Phone (626) 817-4747

622 W Duarte Rd
Suite 101
Arcadia, CA 91007-7606
Phone (323) 442-7122

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.31 of 100Reported as group
Quality
78.96
Promoting interoperability
100
Improvement activities
40
Cost
71.72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G141944CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jules Stein Eye Institute Medical Group Ophthalmology CurrentSince Jun 1, 2016 Accepting new patients
Jules Stein Eye Institute Medical Group CurrentSince Jun 1, 2016 Accepting new patients
UCLA Medical Group Ophthalmology Past Accepting new patients
Pasadena Hospital Association, LTD. Past Accepting new patients
Ahmc San Gabriel Valley Medical Ophthalmology Past Accepting new patients
University of Wisconsin Hospitals and Clinics Authority Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

622 W Duarte Rd
Ste 101
Arcadia, CA 91007
Phone (310) 206-1166

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

625 S Fair Oaks Ave
Ste 280
Pasadena, CA 91105
Phone (626) 304-0070

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1982670402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 S FAIR OAKS AVE STE 280",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052670",
            "telephone_number": "626-817-4747",
            "fax_number": "626-817-4748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IP",
        "first_name": "MICHAEL",
        "middle_name": "SHUN NUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G141944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.