DR. MICHELLE C PHAN O.D.
NPI 1639324619
Optometrist in Rancho Cucamonga, CA

Q: What is Michelle Phan's NPI number?

The NPI number for Michelle Phan is 1639324619. It was assigned to this individual provider in the NPPES registry on November 18, 2008.

Q: What is Michelle Phan'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 Michelle Phan was last updated on November 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 November 18, 2008PECOS EnrolledAccepts Medicare Assignment

10850 ARROW RTE, RANCHO CUCAMONGA, CA 91730(833) 574-2273 Get Directions Write a Review

NPPES record last updated: November 30, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 30, 2021, May 21, 2020 (2 updates tracked since 2020).

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About Dr. Michelle C Phan O.d. NPPES

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

DR. MICHELLE C PHAN O.D. (NPI 1639324619) is an individual optometrist in Rancho Cucamonga, California, licensed in California (13625T) and active in the NPI registry since November 2008. She is enrolled in Medicare PECOS and is a graduate of Illinois College Of Optometry At Chicago (2008).

NPPES Registry Identity

NPI1639324619

Entity TypeIndividualFemale

Primary Taxonomy152W00000X

Provider Legal NameDR. MICHELLE C PHANCredential: O.D.

Location Address10850 ARROW RTERancho Cucamonga, CA 91730-4833

Mailing Address168 S E StSan Bernardino, CA 92401-1920 · (909) 884-4859 · Fax (909) 383-8924

Phone(833) 574-2273

Sole ProprietorNo

Medical School CMSIllinois College Of Optometry At ChicagoGraduated 2008

Enumeration DateNovember 18, 2008

Last NPPES UpdateNovember 30, 20212 updates tracked since enumeration

NPPES CertifiedMay 21, 2020

✔ NPI 1639324619 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 · 13625T

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.

10850 ARROW RTE, Rancho Cucamonga, CA 91730

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Michelle C Phan O.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9133284763

PECOS Enrollment IDI20090216000339

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.

Medicare Billing Reassignment

Medicare enrollment records show Michelle Phan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group

6.6 mi

Health Maintenance Organization

15272 SUMMIT AVE
Fontana, CA 92336

Reassigned Medicare billing, California enrollment
Also billed through NPI 1952333460 (California)
5,228 clinicians in this Medicare group

NPI 1316463763 (877) 608-0044

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91730 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

$136.04 typical visit price

range $59.60 – $179.42

Typical copayment $34.01 (range $14.90 – $44.85)

Most-billed visit code 99204

Established Patient

$74.08 typical visit price

range $19.37 – $146.42

Typical copayment $18.52 (range $4.84 – $36.60)

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 13

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

MR. SAMUEL LISAMA VILLAPANDO

Student in an Organized Health Care Education/Training Program