Individual provider Active NPI

Christine Chizuko Terada, O.D.

  • Optometrist
  • Long Beach, CA
National Provider Identifier
1275619827
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT9749 Issued in CA
Practice address
5512 E Britton Dr Ste 200
Long Beach, CA 90815-3149
Phone
(562) 421-2020
Fax
(562) 594-4696
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT9749 CA Primary

Addresses

Primary practice location

5512 E Britton Dr Ste 200
Long Beach, CA 90815-3149

Mailing address

17281 Mill Cir
Huntington Beach, CA 92647-6210
Phone (714) 847-3659

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
I20050615000513 CA Practitioner - Optometry 6608810171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Katherine M Tanaka MD IncGroup PAC ID 3577505619, 2 clinicians

Practice addresses (Care Compare)

5512 E Britton Dr
Suite 200
Long Beach, CA 90815-3149
Phone (562) 421-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT9749CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Katherine M. Tanaka, M.D., Inc. CurrentSince Feb 22, 2005 Accepting new patients

Locations

5512 E Britton Dr
Ste 200
Long Beach, CA 90815
Phone (562) 421-2020

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.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275619827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17281 MILL CIR",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926476210",
            "telephone_number": "714-847-3659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5512 E BRITTON DR STE 200",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908153149",
            "telephone_number": "562-421-2020",
            "fax_number": "562-594-4696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERADA",
        "first_name": "CHRISTINE",
        "middle_name": "CHIZUKO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT9749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.