Individual provider Active NPI

Kenneth K Sakazaki, OD

  • Optometrist
  • Sacramento, CA
National Provider Identifier
1235297433
Registry record updated Sep 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8578TPG Issued in CA
Practice address
400 O St Ste 102
Sacramento, CA 95814-5327
Phone
(916) 443-3524
Fax
(916) 443-3986
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8578TPG CA Primary

Addresses

Primary practice location

400 O St Ste 102
Sacramento, CA 95814-5327

Mailing address

400 O St Ste 102
Sacramento, CA 95814-5327
Phone (916) 443-3524

Other identifiers 1

IdentifierTypeStateIssuer
SD0085780MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8578TPGCAMDOptometrist
8578CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Third Optometric Care of California PC Optometrist CurrentSince Nov 24, 2021 Accepting new patients
Third Optometric Care of California Optometrist Current Accepting new patients
Sacramento Optometric Group, a Professional Corporation Optometrist CurrentSince Jul 1, 2013 Accepting new patients
Third Optometric Care of California Optometrist CurrentSince Nov 24, 2021 Accepting new patients
DRS. Takahashi & Sakazaki Optometrist PastSince Apr 7, 1994 Accepting new patients
Third Optometric Care of California PC Optometrist Past Accepting new patients

Locations

3333 Quality Dr
Rncho Cordova, CA 95670
Phone (704) 712-0564

400 O St
Ste 102
Sacramento, CA 95814
Phone (916) 443-3524

Organizations & group practices 6

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1235297433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 O ST STE 102",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958145327",
            "telephone_number": "916-443-3524",
            "fax_number": "916-443-3986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 O ST STE 102",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958145327",
            "telephone_number": "916-443-3524",
            "fax_number": "916-443-3986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAKAZAKI",
        "first_name": "KENNETH",
        "middle_name": "K",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8578TPG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0085780",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.