Derrick T. Koo, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

OPT 13260 TPA Issued in CA

Practice address

20568 Stevens Creek Blvd
Cupertino, CA 95014-2130

Phone

(408) 777-9000

Fax

(408) 777-9009

NPI assigned

Aug 6, 2007

Last updated

Jan 30, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Elite Eye Care Optometry Group

  dba Vista Eye Center Optometry

  • Optometrist
  • Cupertino, CA
  • NPI 1841526852
  Authorized official Same address or phone
• First Optometric Care of Northern California PC

  • Optometrist
  • Rancho Cordova, CA
  • NPI 1154972404
  NPD
• First Optometric Care of Northern California PC

  dba Eagle Vision Eye Care Optometric Group

  • Optometrist
  • Sacramento, CA
  • NPI 1457946931
  NPD
• First Optometric Care of Northern California PC

  dba East Hills Vision Care Optometry

  • Optometrist
  • San Jose, CA
  • NPI 1487537452
  NPD

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264809600000",
    "number": "1053502864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20568 STEVENS CREEK BLVD",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950142130",
            "telephone_number": "408-777-9000",
            "fax_number": "408-777-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20568 STEVENS CREEK BLVD",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950142130",
            "telephone_number": "408-777-9000",
            "fax_number": "408-777-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOO",
        "first_name": "DERRICK",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-06",
        "last_updated": "2010-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "OPT 13260 TPA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kay Audrey Knox, PHD
• Hiromi Kobayashi, D.D.S.,M.S.D.
• Brad Koch
• Danielle Y Koh, D.C.
• Soren Koldewyn, LMFT
• Keith H. Kosakura, O.D.
• Andrew S Kouvaris, D.D.S., M.S.D.
• Jill Krafts, LCSW
• Vijayalakshmi Krishnamoorthi, PHYSICAL THERAPIST
• Harini A Krishnapuram, D.D.S

• Corneal and Contact Management Optometrist in Cupertino, CA
• Providers in Cupertino, CA by specialty
• Corneal and Contact Management Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.