Individual provider Active NPI

Stephanie Yoshimura, O.D.

  • Optometrist
  • Sacramento, CA
National Provider Identifier
1356435697
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12309 Issued in CA
Practice address
5773 Greenback LN
Sacramento, CA 95841-2013
Phone
(916) 863-3143
Fax
(916) 863-3148
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12309 CA Primary

Addresses

Primary practice location

5773 Greenback LN
Sacramento, CA 95841-2013

Mailing address

5773 Greenback LN
Sacramento, CA 95841-2013
Phone (916) 863-3143

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address syoshimura@directaddress.net

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
I20040209000881 CA Practitioner - Optometry 4183518483 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Matin Khoshnevis MD IncGroup PAC ID 9335536440, 5 clinicians
Visionary Optometric IncGroup PAC ID 5799158564, 2 clinicians

Practice addresses (Care Compare)

5773 Greenback LN
Sacramento, CA 95841-2013
Phone (916) 863-3143

7900 Zenith Dr
Citrus Heights, CA 95621-1075
Phone (916) 725-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12309CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visionary Optometric Inc Optometrist CurrentSince Jan 1, 2023 Accepting new patients
Matin Khoshnevis MD Inc Optometrist CurrentSince Mar 1, 2022 Accepting new patients
Regents of the University of California CurrentSince Nov 1, 2021 Accepting new patients
Regents of the University of Ca CurrentSince Nov 1, 2021 Accepting new patients
Regents of the Univ of Ca Optometrist CurrentSince Apr 5, 2013 Accepting new patients
Regents of the Univ of Ca CurrentSince Apr 5, 2013 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Heidi Q T Pham-Murphy OD Optometrist PastSince Apr 6, 2010 Accepting new patients
Michael B. Hatashita O.D., an Optometric Corporation Optometrist PastSince Jan 1, 2023 Accepting new patients
Essent PRMC LP Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

7900 Zenith Dr
Citrus Hts, CA 95621
Phone (916) 725-2020

2035 Lyndell Ter
Ste 100
Davis, CA 95616
Phone (530) 668-6000

14264 Innovation Dr
Folsom, CA 95630
Phone (916) 703-2486

1620 E Roseville Pkwy
Ste 200
Roseville, CA 95661
Phone (916) 771-0251

77 Cadillac Dr
Ste 240
Sacramento, CA 95825
Phone (916) 569-4400

77 Cadillac Dr
Ste 101
Sacramento, CA 95825
Phone (916) 286-6162

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

4860 Y St
Ste 200
Sacramento, CA 95817
Phone (916) 734-3761

5773 Greenback Ln
Sacramento, CA 95841
Phone (916) 863-3143

Organizations & group practices 12

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1356435697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5773 GREENBACK LN",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958412013",
            "telephone_number": "916-863-3143",
            "fax_number": "916-863-3148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5773 GREENBACK LN",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958412013",
            "telephone_number": "916-863-3143",
            "fax_number": "916-863-3148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOSHIMURA",
        "first_name": "STEPHANIE",
        "name_prefix": "Ms.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "syoshimura@directaddress.net",
            "affiliation": "N",
            "address_1": "5773 Greenback Ln",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958412013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.