Individual provider Active NPI

Kimi Kaur

  • Optometrist
  • Manteca, CA
National Provider Identifier
1164165692
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
35262 Issued in CA
Practice address
2440 Daniels St
Manteca, CA 95337-6745
Phone
(209) 825-8200
NPI assigned
Apr 13, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 35262 CA Primary

Addresses

Primary practice location

2440 Daniels St
Manteca, CA 95337-6745

Mailing address

1860 Matterhorn St
Manteca, CA 95337-6687
Phone (209) 740-1398

Other practice location 1

5460 E La Palma Ave
Anaheim, CA 92807-2023
Phone (209) 740-1398

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
I20240524001050 CA Practitioner - Optometry 0143662932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

4601 Dale Rd
Modesto, CA 95356-9718
Phone (209) 735-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35262CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group, Inc CurrentSince Apr 10, 2024 Accepting new patients
Permanente Medical Group Inc CurrentSince Apr 10, 2024 Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

4601 Dale Rd
Modesto, CA 95356
Phone (209) 557-1000

1800 Harrison St
Fl 7
Oakland, CA 94612

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Organizations & group practices 2

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": "1649808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1164165692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 MATTERHORN ST",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953376687",
            "telephone_number": "209-740-1398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 DANIELS ST",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953376745",
            "telephone_number": "209-825-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5460 E La Palma Ave",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928072023",
            "country_code": "US",
            "telephone_number": "209-740-1398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAUR",
        "first_name": "KIMI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-13",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manteca, CA

Sources for this page

Verify at the official NPI Registry.