Active NPI
Kimberly Haw, O.D.
- Optometrist
- Fremont, CA
National Provider Identifier
1194922153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 13250
- Practice address
- 3935 Beacon Ave
Suite a
Fremont, CA 94538-1458 - Phone
- (510) 792-9900
- Fax
- (510) 792-9906
- NPI assigned
- Jul 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 13250 | CA | Primary |
Addresses
Primary practice location
3935 Beacon Ave
Suite a
Fremont, CA 94538-1458
Mailing address
3935 Beacon Ave
Suite a
Fremont, CA 94538-1458
Phone (510) 792-9900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13250 | Other | CA | STATELICENSE |
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
- Southern California College of Optometry, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3935 Beacon Ave
Suite a
Fremont, CA 94538-1458
Phone (510) 792-9900
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13250 | CA | MD | Physician Assistant |
Organizations & group practices 1
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
- Fremont, CA
- NPI 1548448178
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701216000000",
"number": "1194922153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3935 BEACON AVE",
"address_2": "SUITE A",
"city": "FREMONT",
"state": "CA",
"postal_code": "945381458",
"telephone_number": "510-792-9900",
"fax_number": "510-792-9906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3935 BEACON AVE",
"address_2": "SUITE A",
"city": "FREMONT",
"state": "CA",
"postal_code": "945381458",
"telephone_number": "510-792-9900",
"fax_number": "510-792-9906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAW",
"first_name": "KIMBERLY",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-02",
"last_updated": "2023-11-29",
"certification_date": "2023-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "13250",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATELICENSE",
"identifier": "13250",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.