Organization Active NPI

Eyevue Optometry, Inc.

  • Optometrist
  • Milpitas, CA
National Provider Identifier
1982725511
Registry record updated Sep 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10481T Issued in CA
Legal business name
EYEVUE OPTOMETRY, INC.
Practice address
61 Serra Way Ste 128
Milpitas, CA 95035-8519
Phone
(408) 262-8998
NPI assigned
Apr 2, 2007
Last updated
Sep 28, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2009

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

Authorized official

Name
Thao BuuNPI 1083793590
Title
Optometrist
Phone
(408) 262-8998

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10481T CA Primary

Addresses

Primary practice location

61 Serra Way Ste 128
Milpitas, CA 95035-8519

Mailing address

61 Serra Way Ste 128
Milpitas, CA 95035-8519

Other identifiers 1

IdentifierTypeStateIssuer
1982725511MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041210000929 CA Part B Supplier - Clinic/Group Practice 3476510496 Receives reassigned benefits from 4 practitioners
Practice locations: Milpitas, CA

National Provider Directory

National Provider Directory

Locations

61 Serra Way
Ste 128
Milpitas, CA 95035
Phone (408) 262-8998

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254096000000",
    "number": "1982725511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 SERRA WAY STE 128",
            "city": "MILPITAS",
            "state": "CA",
            "postal_code": "950358519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 SERRA WAY STE 128",
            "city": "MILPITAS",
            "state": "CA",
            "postal_code": "950358519",
            "telephone_number": "408-262-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEVUE OPTOMETRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2009-09-28",
        "status": "A",
        "authorized_official_last_name": "BUU",
        "authorized_official_first_name": "THAO",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "408-262-8998"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10481T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982725511",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milpitas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.