Individual provider Active NPI

Ayaka Sato, O.D.

  • Optometrist
  • Gardena, CA
National Provider Identifier
1295913770
Registry record updated Feb 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14212 Issued in CA
Practice address
1141 W Redondo Beach Blvd
Gardena, CA 90247-3586
Phone
(310) 767-7814
NPI assigned
Feb 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001703 VA
Optometrist 152W00000X 14212 CA Primary
Optometrist 152W00000X 771 HI

Addresses

Primary practice location

1141 W Redondo Beach Blvd
Gardena, CA 90247-3586

Mailing address

1141 W Redondo Beach Blvd
Ste 101
Gardena, CA 90247-3585
Phone (310) 767-7814

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
I20160307001118 CA Practitioner - Optometry 6305142001 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618001703VAMDOptometrist
14212CAMDAcupuncturist
771HIMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Johns Community Health Current Accepting new patients
St. Johns Community Health CurrentSince Nov 6, 2019 Accepting new patients
St. Johns Community Health CurrentSince Nov 6, 2019 Accepting new patients
Advanced Vision Care a California General Partnership CurrentSince Mar 1, 2020 Accepting new patients
Century Eye Care Medical Center, Inc. PastSince Jan 26, 2016 Accepting new patients

Locations

2115 N Wilmington Ave
Compton, CA 90222
Phone (310) 603-1332

2080 Century Park E
Ste 911
Los Angeles, CA 90067
Phone (310) 229-1220

Organizations & group practices 5

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": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1295913770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 W REDONDO BEACH BLVD",
            "address_2": "STE 101",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473585",
            "telephone_number": "310-767-7814",
            "fax_number": "310-323-3785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 W REDONDO BEACH BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473586",
            "telephone_number": "310-767-7814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SATO",
        "first_name": "AYAKA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-06",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001703",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14212",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "HI",
            "license": "771",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

Verify at the official NPI Registry.