Katherine Mariko Tanaka, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

G58916 Issued in CA

Practice address

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

Phone

(562) 421-2020

NPI assigned

Jun 15, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

University of California, Irvine, California College of Medicine, 1986

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)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Katherine M. Tanaka, M.D., Inc.

  dba Advanced Vision Center

  • Ophthalmology Physician
  • Long Beach, CA
  • NPI 1225115249
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336344878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 1ST ST",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907406002"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANAKA",
        "first_name": "KATHERINE",
        "middle_name": "MARIKO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G58916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesus King Tan, MD
• Joanna Ai Wan Tan, M.D.
• Jofel Tan, OTD, OTR/L
• Mony Chan Tan, NP
• Song N Tan, M.D.
• Leslie Tanaka
• Sakura Tanaka
• Sohrab Tanavoli, D.O
• Ariza Tandoc
• Adric Trinh Tang

• Ophthalmology Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.