Individual provider Active NPI

Eugene Y Tsujimoto, OD

  • Optometrist
  • Fremont, CA
National Provider Identifier
1992765341
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4655T Issued in CA
Practice address
39355 California St
Suite 103
Fremont, CA 94538-1447
Phone
(510) 744-2010
Fax
(510) 744-2015
NPI assigned
Mar 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4655T CA Primary

Addresses

Primary practice location

39355 California St
Suite 103
Fremont, CA 94538-1447

Mailing address

39355 California St
Suite 103
Fremont, CA 94538-1447
Phone (510) 744-2010

Other identifiers 1

IdentifierTypeStateIssuer
GR0022890MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
4655TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fremont Optometric Group Optometrist PastSince Aug 24, 2009 Accepting new patients

Organizations & group practices 1

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": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194998400000",
    "number": "1992765341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39355 CALIFORNIA ST",
            "address_2": "SUITE 103",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381447",
            "telephone_number": "510-744-2010",
            "fax_number": "510-744-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39355 CALIFORNIA ST",
            "address_2": "SUITE 103",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381447",
            "telephone_number": "510-744-2010",
            "fax_number": "510-744-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSUJIMOTO",
        "first_name": "EUGENE",
        "middle_name": "Y",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2007-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "4655T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0022890",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.