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WALNUT SQUARE OPTOMETRY
NPI 1932439304
Optometrist in Berkeley, CA

Active since January 07, 2010
2118 VINE ST, SUITE E, BERKELEY, CA 94709(510) 548-3947(510) 548-3501 Get Directions Write a Review

NPPES record last updated: January 29, 2010. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Walnut Square Optometry NPPES

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

WALNUT SQUARE OPTOMETRY (NPI 1932439304) is a healthcare organization registered as an optometrist in Berkeley, California and active in the NPI registry since January 2010. The organization lists Nicole Jae Sim, President, as its authorized official.

NPPES Registry Identity

NPI1932439304
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameNICOLE JAE SIM OPTOMETRIC, INC
Location Address2118 VINE ST, SUITE EBerkeley, CA 94709-1524
Mailing Address2118 Vine St, Suite EBerkeley, CA 94709-1524 · (510) 548-3947 · Fax (510) 548-3501
Phone(510) 548-3947
Fax(510) 548-3501
Organization SubpartYes
Authorized OfficialNicole Jae SimPresident · (510) 548-3947
Enumeration DateJanuary 7, 2010
Last NPPES UpdateJanuary 29, 2010
✔ NPI 1932439304 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 · 11438TPA
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.
2118 VINE ST, Berkeley, CA 94709
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Other Names 1

Doing Business AsWalnut Square 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, BlueCross BlueShield of Tennessee.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)

Walnut Square Optometry is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Walnut Square Optometry, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Nicole Sim, O.D.
Optometry
NPI 1861577744
2118 VINE ST SUITE E
Berkeley, CA 94709
(510) 548-3947
✔ PECOS✔ Accepts MedicareSame address
Angela Cheung, O.D.
Optometry
NPI 1346658184
3330 GRAND AVE
Oakland, CA 94610
(510) 832-3162
✔ PECOS✔ Accepts Medicare4.8 mi

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 Nicole Jae Sim Optometric, Inc's NPI number?

The NPI number for Nicole Jae Sim Optometric, Inc is 1932439304. It was assigned to this organization in the NPPES registry on January 7, 2010. The provider is doing business as Walnut Square Optometry.

Where is Nicole Jae Sim Optometric, Inc located?

Nicole Jae Sim Optometric, Inc is located at 2118 Vine St Suite E, Berkeley, CA 94709. The listed phone number is (510) 548-3947.

What is Nicole Jae Sim Optometric, Inc's specialty?

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

Is Nicole Jae Sim Optometric, Inc enrolled in Medicare?

Yes. Nicole Jae Sim Optometric, Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Nicole Jae Sim Optometric, Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Optometry, reassign their Medicare billing to Nicole Jae Sim Optometric, 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. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Nicole Jae Sim Optometric, Inc accept?

Health plans from Anthem Blue Cross and Blue Shield and BlueCross BlueShield of Tennessee list Nicole Jae Sim Optometric, Inc 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 Nicole Jae Sim Optometric, Inc was last updated on January 29, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.