Individual provider Active NPI

Carole Lisa Hong, OD

  • Optometrist
  • San Carlos, CA
National Provider Identifier
1982685509
Registry record updated Jan 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9662T Issued in CA
Practice address
1234 Cherry St
San Carlos, CA 94070-3110
Phone
(650) 593-1661
Fax
(650) 595-5203
NPI assigned
Nov 10, 2005
Last updated
Jan 29, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9662T CA Primary

Addresses

Primary practice location

1234 Cherry St
San Carlos, CA 94070-3110

Mailing address

1234 Cherry St
San Carlos, CA 94070-3110
Phone (650) 593-1661

Other identifiers 2

IdentifierTypeStateIssuer
1238570001OtherCAMEDICARE SUPPLY
YYY48725YMedicaidCA

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
I20080409000379 CA Practitioner - Optometry 7719965318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carole L. Hong OD Inc.Group PAC ID 4587948534, 2 clinicians

Practice addresses (Care Compare)

57 El Camino Real
San Carlos, CA 94070-2401
Phone (650) 593-1661

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9662TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Carole L. Hong & Kristina Stasko, PTRS PastSince Feb 1, 1997 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359417600000",
    "number": "1982685509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 CHERRY ST",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940703110",
            "telephone_number": "650-593-1661",
            "fax_number": "650-595-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 CHERRY ST",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940703110",
            "telephone_number": "650-593-1661",
            "fax_number": "650-595-5203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HONG",
        "first_name": "CAROLE",
        "middle_name": "LISA",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-10",
        "last_updated": "2013-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9662T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SUPPLY",
            "identifier": "1238570001",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "YYY48725Y",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Carlos, CA

Sources for this page

Verify at the official NPI Registry.