Individual provider Active NPI

William H Kiernan, OD

  • Optometrist
  • Loma Linda, CA
National Provider Identifier
1174548291
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7661T Issued in CA
Practice address
11370 Anderson St Ste 1800
Loma Linda, CA 92354-3450
Phone
(909) 558-2154
Fax
(909) 558-2180
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 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 7661T CA Primary

Addresses

Primary practice location

11370 Anderson St Ste 1800
Loma Linda, CA 92354-3450

Mailing address

11370 Anderson St Ste 1800
Loma Linda, CA 92354-3450
Phone (909) 558-2154

Other identifiers 1

IdentifierTypeStateIssuer
SD0076610MedicaidCA

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
I20040408000864 CA Practitioner - OptometryPractitioner - Ophthalmology 0143214643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11370 Anderson St
Loma Linda, CA 92354-3450

81 Highland Springs Ave
Beaumont, CA 92223-3170
Phone (909) 558-4000

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7661TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jul 1, 2004 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Optometrist CurrentSince Jul 1, 2004 Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Loma Linda University Children'S Hospital Past Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

11370 Anderson St
Ste 1800
Loma Linda, CA 92354
Phone (909) 558-2154

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

26520 Cactus Ave
Ste 2021
Moreno Valley, CA 92555
Phone (951) 486-5700

2195 Club Center Dr
Ste A
Sn Bernrdno, CA 92408
Phone (909) 835-1750

Interoperability endpoints

  • Direct secure messaging: wkiernan8279@direct.llu.edu

Organizations & group practices 7

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1174548291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11370 ANDERSON ST STE 1800",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543450",
            "telephone_number": "909-558-2154",
            "fax_number": "909-558-2180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11370 ANDERSON ST STE 1800",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543450",
            "telephone_number": "909-558-2154",
            "fax_number": "909-558-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIERNAN",
        "first_name": "WILLIAM",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7661T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0076610",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.