Kimberly Michel, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

14463 Issued in CA

Practice address

1755 Hacienda Dr
Vista, CA 92081-4546

Phone

(760) 631-0654

Fax

(760) 631-0621

NPI assigned

Jul 11, 2012

Sex

Female

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 12, 2021 through Jan 12, 2027

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Kimberly a. Michel, O.D., a Professional Corporation

  • Optometrist
  • Vista, CA
  • NPI 1205454386
  NPD Authorized official
• Milauskas Eye Institute Medical Group II Inc

  • Ophthalmology Physician
  • Rancho Mirage, CA
  • NPI 1235210584

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1104181460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 HACIENDA DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920814546",
            "telephone_number": "760-631-0654",
            "fax_number": "760-631-0621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 HACIENDA DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920814546",
            "telephone_number": "760-631-0654",
            "fax_number": "760-631-0621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHEL",
        "first_name": "KIMBERLY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryann Meza
• Shana Lynn Mezzanatto, RN
• Mi-Med Supply Co., Inc.
• Michael Murasko DDS Inc
• Michael N. Rutman, D.O., a Medical Corporation
• Valerie Marie Michelotti, M.D.
• Microendodontics
• Maritza Mikolich, PSYD, LMFT
• Renee Susette Miles, LCSW
• Cole Edward Milkovich, OTR/L

• Optometrist in Vista, CA
• Providers in Vista, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.