Kellie Michiko Kanamoto, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

34122TLG Issued in CA

Practice address

26585 Agoura Rd Ste 270
Calabasas, CA 91302-1958

Phone

(818) 431-4414

NPI assigned

Oct 8, 2018

Sex

Female

Sole proprietor

No

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Western University of Health Sciences College of Dental Med, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jules Stein Eye Institute Medical GroupGroup PAC ID 5597663740, 118 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.31 of 100Reported as group

Quality

78.96

Promoting interoperability

100

Improvement activities

40

Cost

71.72

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkanamoto1206508@direct.uclahealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jules Stein Eye Institute Medical Group

  • Ophthalmology Physician
  • Los Angeles, CA
  • NPI 1326006966
  Medicare reassignment Care Compare group NPD
• Jules Stein Eye Institute Medical Group

  dba Doheny Eye Center UCLA - Orange County

  • Durable Medical Equipment & Medical Supplies
  • Fountain Valley, CA
  • NPI 1770938292
  NPD
• Duane Decroupet OD a PC

  dba Glendale Optometric Center

  • Optometrist
  • Glendale, CA
  • NPI 1730258476
  NPD (past)
• Regents Univ of Calif Los Angeles

  dba Resnick Neuropsychiatric Hospital at UCLA

  • Psychiatric Hospital
  • Los Angeles, CA
  • NPI 1952308363
  NPD (past)
• UCLA Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1043427248
  NPD (past)

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

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1376018176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26585 AGOURA RD STE 270",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021958",
            "telephone_number": "818-431-4414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Stein Plaza 2nd Floor",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900951968",
            "country_code": "US",
            "telephone_number": "310-206-7955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANAMOTO",
        "first_name": "KELLIE",
        "middle_name": "MICHIKO",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-08",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34122TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eileen Frances Justiniano
• Jessica A Kaczorowski, PH.D.
• Stella Kahn, DDS
• Stacy Kaiser
• Harvey Kalan, M.D.
• Lily Karamat
• Ilona Karapetyan
• Shirel Karkay-Selea
• Ashley Karlin, OTR/L SWC, IBCLC
• Kashani Calabasas Advanced Dental Group a Professional Dental Corporat

• Optometrist in Calabasas, CA
• Providers in Calabasas, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.