Elk Grove Optometry a Professional Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

ELK GROVE OPTOMETRY A PROFESSIONAL CORPORATION

Practice address

9401 E Stockton Blvd
Ste 105
Elk Grove, CA 95624

Phone

(916) 686-4937

Fax

(916) 686-4469

NPI assigned

May 6, 2006

Organization subpart

No

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

Authorized official

Name

Dr. David T Kageyama, ODNPI 1871550574

Title

President

Phone

(916) 686-4937

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David T Kageyama, OD

  • Optometrist
  • Elk Grove, CA
  • NPI 1871550574
  Medicare reassignment Care Compare group NPD Authorized official
• Andrew Hiroshi Kageyama, OD

  • Optometrist
  • Elk Grove, CA
  • NPI 1437882636
  Medicare reassignment Care Compare group NPD
• Janice H Tamai, OD

  • Optometrist
  • Elk Grove, CA
  • NPI 1174589949
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1146873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383004800000",
    "number": "1306895545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9401 E STOCKTON BLVD",
            "address_2": "STE 105",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "95624",
            "telephone_number": "916-686-4937",
            "fax_number": "916-686-4469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 E STOCKTON BLVD",
            "address_2": "STE 105",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "95624",
            "telephone_number": "916-686-4937",
            "fax_number": "916-686-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELK GROVE OPTOMETRY A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-06",
        "last_updated": "2013-10-29",
        "status": "A",
        "authorized_official_last_name": "KAGEYAMA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-686-4937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GDS00190",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elk Grove Hearing Clinic, Inc.
• Elk Grove Home Health Inc
• Elk Grove Medical & Dental Supply
• Elk Grove Medical Supplies, Inc
• Elk Grove Natural Health
• Elk Grove Pediatrics, Inc
• Elk Grove Pharmacy Inc
• Elk Grove Rehab & Counseling Center
• Elk Grove Unified School District
• Elk Grove Urgent Care Inc

• Optometrist in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.