Individual provider Active NPI

Simon Chen, O.D.

  • Optometrist
  • Placentia, CA
National Provider Identifier
1982794525
Registry record updated May 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12755-T Issued in CA
Practice address
1237 E Imperial Hwy
Placentia, CA 92870-1718
Phone
(714) 983-7088
Fax
(714) 983-7263
NPI assigned
Oct 13, 2006
Last updated
May 9, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12755-T CA Primary
Corneal and Contact Management Optometrist 152WC0802X 12755-T CA
Vision Therapy Optometrist 152WV0400X 12755-T CA

Addresses

Primary practice location

1237 E Imperial Hwy
Placentia, CA 92870-1718

Mailing address

1237 E Imperial Hwy
Placentia, CA 92870-1718
Phone (714) 983-7088

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
I20100121000763 CA Practitioner - Optometry 7315089836 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12755-TCAMDVision Therapy Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Chen & Huang Optometry Associates, Inc. Optometrist CurrentSince Dec 17, 2015 Accepting new patients
Paul S. Crismon, O.D. Inc CurrentSince Nov 29, 2009 Accepting new patients

Locations

13800 San Antonio Dr
Norwalk, CA 90650
Phone (562) 864-6535

1237 E Imperial Hwy
Placentia, CA 92870
Phone (714) 983-7088

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462752000000",
    "number": "1982794525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 E IMPERIAL HWY",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928701718",
            "telephone_number": "714-983-7088",
            "fax_number": "714-983-7263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 E IMPERIAL HWY",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928701718",
            "telephone_number": "714-983-7088",
            "fax_number": "714-983-7263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "SIMON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2016-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12755-T",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "12755-T",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "CA",
            "license": "12755-T",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placentia, CA

Sources for this page

Verify at the official NPI Registry.