Active NPI
Evan Kiyoshi Yamashita, OD
- Optometrist
- Kingsburg, CA
National Provider Identifier
1225723687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 35401
- Practice address
- 1621 Lewis St
Kingsburg, CA 93631-1923 - Phone
- (559) 897-8974
- NPI assigned
- Apr 10, 2023
- Sex
- Male
- 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 | 35401 | CA | Primary |
Addresses
Primary practice location
1621 Lewis St
Kingsburg, CA 93631-1923
Mailing address
1621 Lewis St
Kingsburg, CA 93631-1923
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230505001491 | CA | Practitioner - Optometry | 3072978543 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681084800000",
"number": "1225723687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1621 LEWIS ST",
"city": "KINGSBURG",
"state": "CA",
"postal_code": "936311923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1621 LEWIS ST",
"city": "KINGSBURG",
"state": "CA",
"postal_code": "936311923",
"telephone_number": "559-897-8974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAMASHITA",
"first_name": "EVAN",
"middle_name": "KIYOSHI",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-04-10",
"last_updated": "2023-04-10",
"certification_date": "2023-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "35401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingsburg, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.