ELAINE PYNG OETOMO
NPI 1235798174
Optometrist in Glendale, AZ

Q: What is Elaine Oetomo's NPI number?

The NPI number for Elaine Oetomo is 1235798174. It was assigned to this individual provider in the NPPES registry on June 12, 2019.

Q: What is Elaine Oetomo's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Elaine Oetomo was last updated on January 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since June 12, 2019PECOS Enrolled

9340 W NORTHERN AVE STE 120, GLENDALE, AZ 85305(602) 794-1608 Get Directions Write a Review

NPPES record last updated: January 24, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Elaine Pyng Oetomo NPPES

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

ELAINE PYNG OETOMO (NPI 1235798174) is an individual optometrist in Glendale, Arizona, licensed in Arizona (OPT-002345) and active in the NPI registry since June 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1235798174

Entity TypeIndividualFemale

Primary Taxonomy152W00000X

Provider Legal NameELAINE PYNG OETOMO

Location Address9340 W NORTHERN AVE STE 120Glendale, AZ 85305-1148

Mailing Address39 Deer TrakIrvine, CA 92618-8812

Phone(602) 794-1608

Sole ProprietorNo

Enumeration DateJune 12, 2019

Last NPPES UpdateJanuary 24, 2024

NPPES CertifiedJanuary 24, 2024

✔ NPI 1235798174 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 AZ · OPT-002345

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.

9340 W NORTHERN AVE STE 120, Glendale, AZ 85305

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Elaine Pyng Oetomo is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85305 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$127.71 typical visit price

range $55.44 – $168.60

Typical copayment $31.92 (range $13.86 – $42.15)

Most-billed visit code 99204

Established Patient

$69.24 typical visit price

range $17.72 – $137.41

Typical copayment $17.31 (range $4.43 – $34.35)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NATIONAL VISION INC

Technician/Technologist (Optician)

9340 W NORTHERN AVE STE 120
GLENDALE, AZ 85305

Maricopa County (602) 794-1608

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 Elaine Oetomo's NPI number?

The NPI number for Elaine Oetomo is 1235798174. It was assigned to this individual provider in the NPPES registry on June 12, 2019.

Where is Elaine Oetomo located?

Elaine Oetomo practices at 9340 W Northern Ave Ste 120, Glendale, AZ 85305. The listed phone number is (602) 794-1608.

What is Elaine Oetomo's specialty?

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

Is Elaine Oetomo enrolled in Medicare?

Yes. Elaine Oetomo is registered in the Medicare PECOS enrollment system.

What insurance does Elaine Oetomo accept?

Health plans from Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana and Blue Cross and Blue Shield of Montana and 4 other insurers list Elaine Oetomo 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 Elaine Oetomo was last updated on January 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.