Individual provider Active NPI

Kaitlyn Tsou, O.D.

  • Optometrist
  • Anaheim, CA
National Provider Identifier
1407603780
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
35968 Issued in CA
Practice address
5460 E la Palma Ave
Anaheim, CA 92807-2023
Phone
(714) 463-7500
NPI assigned
May 3, 2024
Last updated
May 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 35968 CA Primary

Addresses

Primary practice location

5460 E la Palma Ave
Anaheim, CA 92807-2023

Mailing address

17592 Wayne Ave
Irvine, CA 92614-6658
Phone (949) 228-6616

Other practice location 1

17592 Wayne Ave
Irvine, CA 92614-6658
Phone (949) 228-6616

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
I20250613002171 CA Practitioner - Optometry 2466963731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marshall B Ketchum UniversityGroup PAC ID 9739075177, 56 clinicians

Practice addresses (Care Compare)

5460 E la Palma Ave
Anaheim, CA 92807-2023
Phone (714) 463-7520

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35968CAMDLicensed Psychiatric Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Marshall B. Ketchum University CurrentSince Jul 1, 2025 Accepting new patients
Marshall B. Ketchum University Optometrist Current Accepting new patients

Locations

5460 E La Palma Ave
Anaheim, CA 92807
Phone (714) 463-7500

3916 S Broadway
Los Angeles, CA 90037
Phone (323) 234-9137

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1714694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1407603780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17592 WAYNE AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146658",
            "telephone_number": "949-228-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5460 E LA PALMA AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928072023",
            "telephone_number": "714-463-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17592 Wayne Ave",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926146658",
            "country_code": "US",
            "telephone_number": "949-228-6616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TSOU",
        "first_name": "KAITLYN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-03",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.