Individual provider Active NPI

Katherine Makedonsky, OD

  • Optometrist
  • Alameda, CA
National Provider Identifier
1154843779
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT33727TLG Issued in CA
Practice address
847 Marina Village Pkwy
Alameda, CA 94501-1035
Phone
(510) 337-7970
Fax
(510) 337-7973
NPI assigned
Jul 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT33727TLG CA Primary

Addresses

Primary practice location

847 Marina Village Pkwy
Alameda, CA 94501-1035

Mailing address

1234 Mountain Side CT
Concord, CA 94521-5508
Phone (925) 457-8632

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
I20180417002307 CA Practitioner - Optometry 6709149172 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33727CAMDGeneral Practice Dentistry
OPT33727TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher P. Young OD, Inc. Optometrist CurrentSince Oct 16, 2024 Accepting new patients
Susan C, Lodenquai, O.D. Inc Optometrist PastSince Jun 1, 2022 Accepting new patients
East Bay Eye Centers Medical Corporation PastSince Mar 26, 2018 Accepting new patients

Locations

847 Marina Village Pkwy
Alameda, CA 94501
Phone (408) 504-6053

Organizations & group practices 3

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": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1154843779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 MOUNTAIN SIDE CT",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945215508",
            "telephone_number": "925-457-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "847 MARINA VILLAGE PKWY",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945011035",
            "telephone_number": "510-337-7970",
            "fax_number": "510-337-7973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKEDONSKY",
        "first_name": "KATHERINE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-14",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT33727TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alameda, CA

Sources for this page

Verify at the official NPI Registry.