Active NPI
Kristen Ying Oda, OD
- Optometrist
- San Jose, CA
National Provider Identifier
1174048698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 33814LTG
- Practice address
- 214 Jackson St
San Jose, CA 95112-3201 - Phone
- (408) 293-3730
- NPI assigned
- Aug 5, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 33814LTG | CA | Primary |
Addresses
Primary practice location
214 Jackson St
San Jose, CA 95112-3201
Mailing address
1122 Kovanda Way
Milpitas, CA 95035-3130
Phone (408) 420-6925
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of California - School of Optometry, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
214 Jackson St
San Jose, CA 95112-3201
Phone (408) 293-3730
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33814 | CA | MD | Dentist |
| 33814LTG | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fifth Optometric Care of California | Optometrist | Current | Accepting new patients |
| Fifth Optometric Care of California | Optometrist | Current | Accepting new patients |
| Shinmori Optometry, Inc. | Optometrist | Current | Accepting new patients |
| Fifth Optometric Care of California | Optometrist | Current | Accepting new patients |
Locations
3333 Quality Dr
Rncho Cordova, CA 95670
Phone (704) 712-0564
214 Jackson St
San Jose, CA 95112
Phone (408) 293-3730
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.
-
- Optometrist
- San Jose, CA
- NPI 1215627914
-
- Optometrist
- Taft, CA
- NPI 1699504746
-
- Optometrist
- San Jose, CA
- NPI 1871271353
-
- Optometrist
- San Jose, CA
- NPI 1013985266
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1501891200000",
"number": "1174048698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1122 KOVANDA WAY",
"city": "MILPITAS",
"state": "CA",
"postal_code": "950353130",
"telephone_number": "408-420-6925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "214 JACKSON ST",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951123201",
"telephone_number": "408-293-3730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODA",
"first_name": "KRISTEN",
"middle_name": "YING",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-05",
"last_updated": "2017-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "33814LTG",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2017; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.