Individual provider Active NPI

Michael A. Kling, OD

  • Optometrist
  • San Diego, CA
National Provider Identifier
1235214479
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10135T Issued in CA
Practice address
3945 1St Ave
San Diego, CA 92103-3015
Phone
(619) 295-4194
Fax
(619) 295-4930
NPI assigned
Oct 26, 2006
Last updated
Dec 28, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10135T CA Primary

Addresses

Primary practice location

3945 1St Ave
San Diego, CA 92103-3015

Mailing address

3945 1St Ave
San Diego, CA 92103-3015
Phone (619) 295-4194

Other identifiers 1

IdentifierTypeStateIssuer
SD0101350MedicaidCA

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
I20110427000268 CA Practitioner - Optometry 5890795504 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michael a Kling OD IncGroup PAC ID 7719921691, 3 clinicians

Practice addresses (Care Compare)

3434 4TH Ave
San Diego, CA 92103-4911
Phone (619) 222-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10135TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Invision Optometry Ventures, Inc Optometrist CurrentSince Jan 2, 2022 Accepting new patients
Vision Boutique Optometry Optometrist PastSince Jan 2, 2022 Accepting new patients

Locations

3830 Valley Centre Dr
Ste 703
San Diego, CA 92130
Phone (858) 350-4980

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293494400000",
    "number": "1235214479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3945 1ST AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033015",
            "telephone_number": "619-295-4194",
            "fax_number": "619-295-4930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3945 1ST AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033015",
            "telephone_number": "619-295-4194",
            "fax_number": "619-295-4930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLING",
        "first_name": "MICHAEL",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2010-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10135T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0101350",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.