Individual provider Active NPI

Ekaterina Golub, OD

  • Optometrist
  • Rancho Cordova, CA
National Provider Identifier
1265168223
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
35340 Issued in CA
Practice address
11260 White Rock Rd
Rancho Cordova, CA 95742-6571
Phone
(916) 724-2265
Fax
(916) 357-7867
NPI assigned
Aug 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 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 35340 CA Primary

Addresses

Primary practice location

11260 White Rock Rd
Rancho Cordova, CA 95742-6571

Mailing address

11260 White Rock Rd
Rancho Cordova, CA 95742-6571
Phone (916) 724-2265

Other practice location 1

2409 15th St
Sacramento, CA 95818-2238
Phone (916) 443-8034

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
I20221111001133 CA Practitioner - Optometry 9133596638 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35340CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Greenhaven Optometry CurrentSince Oct 26, 2022 Accepting new patients
Jessica Huynh OD PC Optometrist PastSince Oct 1, 2014 Accepting new patients
Kubo & Kubo, O.D.S Optometrist Past Accepting new patients

Locations

7410 Greenhaven Dr
Ste 140
Sacramento, CA 95831
Phone (916) 421-1278

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1659312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1265168223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11260 WHITE ROCK RD",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "957426571",
            "telephone_number": "916-724-2265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11260 WHITE ROCK RD",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "957426571",
            "telephone_number": "916-724-2265",
            "fax_number": "916-357-7867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2409 15th St",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958182238",
            "country_code": "US",
            "telephone_number": "916-443-8034",
            "fax_number": "916-442-6010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLUB",
        "first_name": "EKATERINA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-01",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cordova, CA

Sources for this page

Verify at the official NPI Registry.