Individual provider Active NPI

Kevin Tom

  • Optometrist
  • Salinas, CA
National Provider Identifier
1043882830
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34828 Issued in CA
Practice address
20141 Anza Cir
Salinas, CA 93908-1222
Phone
(831) 262-0207
NPI assigned
Jul 12, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34828 CA Primary

Addresses

Primary practice location

20141 Anza Cir
Salinas, CA 93908-1222

Mailing address

20141 Anza Cir
Salinas, CA 93908-1222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221130000870 CA Practitioner - Optometry 9830567577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tram Le OD IncGroup PAC ID 9830569318, 2 clinicians

Practice addresses (Care Compare)

801 Tioga Ave
Sand City, CA 93955-3050
Phone (831) 899-4185

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34828CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Tram Le OD, Inc Optometrist CurrentSince Nov 1, 2022 Accepting new patients

Locations

801 Tioga Ave
Seaside, CA 93955
Phone (831) 899-2481

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1043882830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20141 ANZA CIR",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939081222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20141 ANZA CIR",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939081222",
            "telephone_number": "831-262-0207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOM",
        "first_name": "KEVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-12",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salinas, CA

Sources for this page

Verify at the official NPI Registry.