STATE STREET OPTOMETRY
NPI 1720591480
Optometrist in Redlands, CA

Q: What is Jeffry Wu O.D. Professional Corporation's specialty?

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

Active since November 15, 2017

112 E STATE ST, REDLANDS, CA 92373(909) 792-2280(909) 792-4872 Get Directions Write a Review

NPPES record last updated: July 20, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 20, 2020, Nov 15, 2017 (2 updates tracked since 2017).

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About State Street Optometry NPPES

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

STATE STREET OPTOMETRY (NPI 1720591480) is a healthcare organization registered as an optometrist in Redlands, California and active in the NPI registry since November 2017. The organization lists Jeffry Wu, President, as its authorized official.

NPPES Registry Identity

NPI1720591480

Entity TypeOrganization

Primary Taxonomy152W00000X

Legal Business NameJEFFRY WU O.D. PROFESSIONAL CORPORATION

Location Address112 E STATE STRedlands, CA 92373-4756

Mailing Address112 E State StRedlands, CA 92373-4756 · (909) 792-2280 · Fax (909) 792-4872

Phone(909) 792-2280

Fax(909) 792-4872

Organization SubpartNo

Authorized OfficialJeffry WuPresident · (909) 792-2280

Enumeration DateNovember 15, 2017

Last NPPES UpdateJuly 20, 20202 updates tracked since enumeration

NPPES CertifiedJuly 20, 2020

✔ NPI 1720591480 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in CA · 15020

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.

Also ListedOptometrist · Corneal and Contact ManagementTaxonomy 152WC0802X · License 15020 (CA)

Also ListedOptometrist · PediatricsTaxonomy 152WP0200X · License 15020 (CA)

Also ListedOptometrist · Occupational VisionTaxonomy 152WX0102X · License 15020 (CA)

112 E STATE ST, Redlands, CA 92373

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Other Names 1

Doing Business AsState Street Optometry

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, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.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)

State Street 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 State Street Optometry, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jeffry Wu, O.D.

Optometry

NPI 1679989339

112 E STATE ST
Redlands, CA 92373

(909) 792-2280

✔ 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 Jeffry Wu O.D. Professional Corporation's NPI number?

The NPI number for Jeffry Wu O.D. Professional Corporation is 1720591480. It was assigned to this organization in the NPPES registry on November 15, 2017. The provider is doing business as State Street Optometry.

Where is Jeffry Wu O.D. Professional Corporation located?

Jeffry Wu O.D. Professional Corporation is located at 112 E State St, Redlands, CA 92373. The listed phone number is (909) 792-2280.

What is Jeffry Wu O.D. Professional Corporation's specialty?

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

Is Jeffry Wu O.D. Professional Corporation enrolled in Medicare?

Yes. Jeffry Wu O.D. Professional Corporation is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jeffry Wu O.D. Professional Corporation?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Jeffry Wu O.D. Professional Corporation. 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 Jeffry Wu O.D. Professional Corporation accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and BlueCross BlueShield of Tennessee list Jeffry Wu O.D. Professional Corporation 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 Jeffry Wu O.D. Professional Corporation was last updated on July 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.