Individual provider Active NPI

Jennie Yoko Kageyama, OD

  • Ophthalmology Physician
  • Los Angeles, CA
National Provider Identifier
1447274220
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
11155 Issued in CA
Practice address
200 Stein Plaza
Los Angeles, CA 90095-7065
Phone
(310) 825-5000
NPI assigned
Jul 26, 2006
Last updated
Jan 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 11155 CA Primary

Addresses

Primary practice location

200 Stein Plaza
Los Angeles, CA 90095-7065

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other identifiers 1

IdentifierTypeStateIssuer
SD0111550MedicaidCA

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
I20090603000194 CA Practitioner - Optometry 0042360612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

622 W Duarte Rd
Suite 101
Arcadia, CA 91007-7606
Phone (323) 442-7122

Hospital & facility affiliations

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jules Stein Eye Institute Medical Group Ophthalmology CurrentSince Apr 13, 2009 Accepting new patients
Jules Stein Eye Institute Medical Group CurrentSince Apr 13, 2009 Accepting new patients
UCLA Medical Group Ophthalmology Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

622 W Duarte Rd
Ste 101
Arcadia, CA 91007
Phone (310) 206-1166

100 Stein Plz
Rm 1340
Los Angeles, CA 90095
Phone (310) 206-1166

200 Stein Plz
Los Angeles, CA 90095
Phone (310) 206-7202

200 Stein Plz Ucla
Los Angeles, CA 90095
Phone (310) 267-3937

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

Interoperability endpoints

  • Direct secure messaging: jkageyama38204@direct.uclahealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1447274220",
    "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": "200 STEIN PLAZA",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900957065",
            "telephone_number": "310-825-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAGEYAMA",
        "first_name": "JENNIE",
        "middle_name": "YOKO",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "11155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0111550",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.