Individual provider Active NPI

Kerry W H Feng, OD

  • Optometrist
  • San Leandro, CA
National Provider Identifier
1447074216
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT35875 Issued in CA
Practice address
15251 E 14TH St # B
San Leandro, CA 94578-1905
Phone
(510) 481-2121
NPI assigned
Nov 8, 2024
Last updated
Nov 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT35875 CA Primary

Addresses

Primary practice location

15251 E 14TH St # B
San Leandro, CA 94578-1905

Mailing address

1331 136TH Ave
San Leandro, CA 94578-2549
Phone (510) 463-7652

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
I20241204003822 CA Practitioner - Optometry 3971039678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11780 San Pablo Ave
Suite B
El Cerrito, CA 94530-7103
Phone (510) 234-1730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35875CAMDMarriage & Family Therapist
OPT35875CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Geronimo & Leong, Professional Optometric Corporation Optometrist CurrentSince Nov 10, 2024 Accepting new patients
Fifth Optometric Care of California Optometrist Current Accepting new patients
Richard Wu, O.D., a Professional Corporation Optometrist CurrentSince Nov 10, 2024 Accepting new patients
Fifth Optometric Care of California Optometrist CurrentSince Dec 2, 2024 Accepting new patients
Fifth Optometric Care of California Optometrist CurrentSince Dec 2, 2024 Accepting new patients
Fifth Optometric Care of California Optometrist Past Accepting new patients

Locations

11780 San Pablo Ave
Ste B
El Cerrito, CA 94530
Phone (510) 234-1730

3333 Quality Dr
Rncho Cordova, CA 95670
Phone (704) 712-0564

15251 E 14th St
#B
San Leandro, CA 94578
Phone (510) 481-2121

Organizations & group practices 6

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": "1731024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1447074216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 136TH AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945782549",
            "telephone_number": "510-463-7652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15251 E 14TH ST # B",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945781905",
            "telephone_number": "510-481-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENG",
        "first_name": "KERRY",
        "middle_name": "W H",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-08",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT35875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

Verify at the official NPI Registry.