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EYEDENTITY VISION OPTOMETRY
NPI 1255514642
Clinic/Center in San Francisco, CA

Active since December 09, 2007
2786 DIAMOND ST, SAN FRANCISCO, CA 94131(415) 334-2020(415) 681-9268 Get Directions Write a Review

NPPES record last updated: October 11, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Eyedentity Vision Optometry NPPES

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

EYEDENTITY VISION OPTOMETRY (NPI 1255514642) is a healthcare organization registered as a clinic/center in San Francisco, California and active in the NPI registry since December 2007. The organization maintains a secondary practice location in South San Francisco and lists Carrie Lee, President, as its authorized official.

NPPES Registry Identity

NPI1255514642
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameEYEDENTITY VISION OPTOMETRY, INC.
Location Address2786 DIAMOND STSan Francisco, CA 94131-3057
Mailing Address2786 Diamond StSan Francisco, CA 94131-3057 · (415) 334-2020 · Fax (415) 681-9268
Phone(415) 334-2020
Fax(415) 681-9268
Organization SubpartNo
Authorized OfficialCarrie LeePresident · (415) 334-2020
Enumeration DateDecember 9, 2007
Last NPPES UpdateOctober 11, 2021
NPPES CertifiedOctober 11, 2021
✔ NPI 1255514642 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in CA · 12604
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
2786 DIAMOND ST, San Francisco, CA 94131
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Other Names 1

Doing Business AsEyedentity Vision Optometry

Secondary Practice Location 1

Location 1601 Gateway Blvd Ste 220South San Francisco, CA 94080-7400 · Phone (650) 871-9200 · Fax (650) 871-6026

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Eyedentity Vision Optometry 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 Eyedentity Vision Optometry, which bills Medicare for the services this clinician delivers.

Clinician (1)

Carrie Lee, O.D.
Optometry
NPI 1760474142
2786 DIAMOND ST
San Francisco, CA 94131
(415) 334-2020
✔ PECOS✔ Accepts MedicareSame 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 Eyedentity Vision Optometry, Inc.'s NPI number?

The NPI number for Eyedentity Vision Optometry, Inc. is 1255514642. It was assigned to this organization in the NPPES registry on December 9, 2007. The provider is doing business as Eyedentity Vision Optometry.

Where is Eyedentity Vision Optometry, Inc. located?

Eyedentity Vision Optometry, Inc. is located at 2786 Diamond St, San Francisco, CA 94131. The listed phone number is (415) 334-2020.

What is Eyedentity Vision Optometry, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Eyedentity Vision Optometry, Inc. enrolled in Medicare?

Yes. Eyedentity Vision Optometry, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Eyedentity Vision Optometry, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Eyedentity Vision Optometry, Inc.. 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.

When was this NPI record last updated?

The NPPES record for Eyedentity Vision Optometry, Inc. was last updated on October 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.