SUMMIT OPTOMETRIC EYECARE
NPI 1053757039
Optometrist in Simi Valley, CA

Q: What is Summit Optometric Eyecare's NPI number?

The NPI number for Summit Optometric Eyecare is 1053757039. It was assigned to this organization in the NPPES registry on May 16, 2013.

Q: What is Summit Optometric Eyecare's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Active since May 16, 2013

690 E LOS ANGELES AVE, SUITE A, SIMI VALLEY, CA 93065(626) 376-3513(805) 250-1001 Get Directions Write a Review

NPPES record last updated: August 5, 2013. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Summit Optometric Eyecare NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUMMIT OPTOMETRIC EYECARE (NPI 1053757039) is a healthcare organization registered as an optometrist in Simi Valley, California and active in the NPI registry since May 2013. The organization lists John Ilsun Ryu, Ceo/optometrist, as its authorized official.

NPPES Registry Identity

NPI1053757039

Entity TypeOrganization

Primary Taxonomy152W00000X

Legal Business NameSUMMIT OPTOMETRIC EYECARE

Location Address690 E LOS ANGELES AVE, SUITE ASimi Valley, CA 93065-1857

Mailing Address690 E Los Angeles Ave, Suite ASimi Valley, CA 93065-1857 · (626) 376-3513 · Fax (805) 250-1001

Phone(626) 376-3513

Fax(805) 250-1001

Organization SubpartNo

Authorized OfficialJohn Ilsun RyuCeo/optometrist · (626) 376-3513

Enumeration DateMay 16, 2013

Last NPPES UpdateAugust 5, 2013

✔ NPI 1053757039 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in CA · 11209T

Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

690 E LOS ANGELES AVE, Simi Valley, CA 93065

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Other Identifiers 2

Medicare PINHF937ZCA

Medicare UPINU92617CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Summit Optometric Eyecare is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Summit Optometric Eyecare, which bills Medicare for the services this clinician delivers.

Clinician (1)

John Ryu, O.D.

Optometry

NPI 1609946847

690 E LOS ANGELES AVE SUITE A
Simi Valley, CA 93065

(626) 376-3513

✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Summit Optometric Eyecare's NPI number?

The NPI number for Summit Optometric Eyecare is 1053757039. It was assigned to this organization in the NPPES registry on May 16, 2013.

Where is Summit Optometric Eyecare located?

Summit Optometric Eyecare is located at 690 E Los Angeles Ave Suite A, Simi Valley, CA 93065. The listed phone number is (626) 376-3513.

What is Summit Optometric Eyecare's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Summit Optometric Eyecare enrolled in Medicare?

Yes. Summit Optometric Eyecare is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Summit Optometric Eyecare?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Summit Optometric Eyecare. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Summit Optometric Eyecare accept?

Health plans from Anthem Blue Cross and Blue Shield list Summit Optometric Eyecare as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Summit Optometric Eyecare was last updated on August 5, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.