TINA KHIEU OD
NPI 1962031617
Optometrist in San Diego, CA

Q: What is Tina Khieu's NPI number?

The NPI number for Tina Khieu is 1962031617. It was assigned to this individual provider in the NPPES registry on April 5, 2020.

Q: What is Tina Khieu'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 Tina Khieu was last updated on September 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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 April 05, 2020PECOS Enrolled

5680 BALBOA AVE, SAN DIEGO, CA 92111(858) 278-2837(858) 278-2834 Get Directions Write a Review

NPPES record last updated: September 3, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 3, 2026, Jul 13, 2023, Sep 22, 2021 and 1 more (4 updates tracked since 2020).

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About Tina Khieu Od NPPES

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

TINA KHIEU OD (NPI 1962031617) is an individual optometrist in San Diego, California, licensed in California (34777) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962031617

Entity TypeIndividualFemale

Primary Taxonomy152W00000X

Provider Legal NameTINA KHIEUCredential: OD

Location Address5680 BALBOA AVESan Diego, CA 92111-2706

Mailing Address5680 Balboa AveSan Diego, CA 92111-2706 · (858) 278-2837 · Fax (858) 278-2834

Phone(858) 278-2837

Fax(858) 278-2834

Sole ProprietorNo

Enumeration DateApril 5, 2020

Last NPPES UpdateSeptember 3, 20264 updates tracked since enumeration

NPPES CertifiedSeptember 3, 2026

✔ NPI 1962031617 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in CA · 34777

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 ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

5680 BALBOA AVE, San Diego, CA 92111

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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 Louisiana, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tina Khieu Od is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Tina Khieu reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Chan Family Vision Care Optometric Inc

493 mi

Optometrist

360 SIERRA COLLEGE DR STE 100
Grass Valley, CA 95945

Reassigned Medicare billing, California enrollment
4 clinicians in this Medicare group

NPI 1699323329 (530) 273-3190

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

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient complete exam of visual system 92014

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

28 services28 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92111 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

$140.22 typical visit price

range $62.10 – $184.71

Typical copayment $35.05 (range $15.52 – $46.17)

Most-billed visit code 99204

Established Patient

$76.87 typical visit price

range $20.62 – $151.42

Typical copayment $19.21 (range $5.15 – $37.85)

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 9

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

MERIAH BACON PHARMD, RPH

Pharmacist