Individual provider Active NPI

Jeffrey Kamo, OD

  • Corneal and Contact Management Optometrist
  • Berkeley, CA
National Provider Identifier
1104503432
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
OPT35504-TLG Issued in CA
Practice address
200 Minor Hall
Berkeley, CA 94720
Phone
(510) 642-2020
NPI assigned
Jun 28, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X OPT35504-TLG CA Primary

Addresses

Primary practice location

200 Minor Hall
Berkeley, CA 94720

Mailing address

200 Minor Hall
Berkeley, CA 94720
Phone (510) 642-2020

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
I20231006002867 CA Practitioner - Optometry 1254786429 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11605 Goetting Ave
Tustin, CA 92782-3334

1545 Adams Ave
Suite 100
Costa Mesa, CA 92626-3875

230 Minor Hall
Berkeley, CA 94720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT35504-TLGCAMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Woodbridge Optometry, Inc. CurrentSince Jul 1, 2024 Accepting new patients
Regents of the University of California at Berkeley CurrentSince Sep 24, 2023 Accepting new patients
Dr. Alissa Wald and Associates Optometry, Inc. CurrentSince Jul 15, 2024 Accepting new patients
Christopher P. Likens & Nancy L. Wilson PTR Past Accepting new patients

Locations

200 Minor Hall
Ste 384A
Berkeley, CA 94720
Phone (510) 642-7844

200 Minor Hall
Berkeley, CA 94720
Phone (510) 642-0945

1545 Adams Ave
Ste 100
Costa Mesa, CA 92626
Phone (714) 545-9162

4505 Barranca Pkwy
Ste C
Irvine, CA 92604
Phone (949) 857-0676

Organizations & group practices 4

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": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1104503432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MINOR HALL",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94720",
            "telephone_number": "510-642-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MINOR HALL",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94720",
            "telephone_number": "510-642-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMO",
        "first_name": "JEFFREY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "OPT35504-TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.