GOLDEN SAN GABRIEL OPTOMETRIC VISION CENTER
NPI 1740216936
Optometrist in San Gabriel, CA
About Golden San Gabriel Optometric Vision Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GOLDEN SAN GABRIEL OPTOMETRIC VISION CENTER (NPI 1740216936) is a healthcare organization registered as an optometrist in San Gabriel, California and active in the NPI registry since June 2006. The organization lists Jiyen Shin, Owner/optometris, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Golden San Gabriel Optometric Vision Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
18Medicare enrollment records show 18 clinicians reassign Medicare billing to Golden San Gabriel Optometric Vision Center, which bills Medicare for the services they deliver. Of these, 8 practice at this address and 12 within 10 miles. They are listed nearest first.
Clinicians, nearest first (18)
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 Golden San Gabriel Optometric Vision Center's NPI number?
The NPI number for Golden San Gabriel Optometric Vision Center is 1740216936. It was assigned to this organization in the NPPES registry on June 23, 2006.
Where is Golden San Gabriel Optometric Vision Center located?
Golden San Gabriel Optometric Vision Center is located at 140 W Valley Blvd #115, San Gabriel, CA 91776. The listed phone number is (626) 288-8023.
What is Golden San Gabriel Optometric Vision Center's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Golden San Gabriel Optometric Vision Center enrolled in Medicare?
Yes. Golden San Gabriel Optometric Vision Center is registered in the Medicare PECOS enrollment system.
When is Golden San Gabriel Optometric Vision Center's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Golden San Gabriel Optometric Vision Center?
According to the CMS Revalidation Reassignment List (October 2026 release), 18 clinicians, all in Optometry, reassign their Medicare billing to Golden San Gabriel Optometric Vision Center. 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. Of these, 8 practice at this address and 12 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Golden San Gabriel Optometric Vision Center was last updated on March 27, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Golden San Gabriel Optometric Vision Center · NPI 1740216936
Optometrist organization in San Gabriel, California. Organization record, active in the CMS NPPES registry since June 23, 2006.
## Identity
- **NPI:** 1740216936 (Entity type: Organization)
- **Enumerated:** June 23, 2006
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Organization subpart:** No
- **Authorized official:** Jiyen Shin, OWNER/OPTOMETRIS
## Practice location
- **Address:** 140 W VALLEY BLVD, #115, San Gabriel, CA 91776-3760
- **Phone:** (626) 288-8023 · **Fax:** (626) 288-8326
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, California, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 18 clinicians (Optometry) reassign Medicare billing to this organization (form CMS-855R); 8 practice at this address and 12 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 27, 2014
- **Other identifiers:** Medicaid GSD001490 (CA); Medicare ID-Type Unspecified WY154 (CA); Medicare PIN WY154 (CA)
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Source: [NPI Profile](https://npiprofile.com/npi/1740216936) · Data from the CMS NPPES public registry.