Individual provider Active NPI

Kalie Marie McCartin, O.D.

  • Optometrist
  • Torrance, CA
National Provider Identifier
1508366584
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
33875TLG Issued in CA
Practice address
2790 Skypark Dr Ste 115
Torrance, CA 90505-5331
Phone
(424) 407-3303
Fax
(424) 407-3309
NPI assigned
Feb 16, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 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 33875TLG CA Primary

Addresses

Primary practice location

2790 Skypark Dr Ste 115
Torrance, CA 90505-5331

Mailing address

2614 Gage Ave
Huntington Park, CA 90255
Phone (323) 282-2811

Other practice location 1

31461 Rancho Viejo Rd Ste 103
San Juan Capistrano, CA 92675-1865
Phone (424) 407-3303

Other practice location 2

2424 SE Bristol St Ste 200
Newport Beach, CA 92660-0757
Phone (424) 407-3303

Other practice location 3

10801 National Blvd Ste 430
Los Angeles, CA 90064-4139
Phone (424) 407-3303

Other names 1

  • Ms. Kalie Marie Baker Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
33875TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
National Vision Inc Past Accepting new patients

Organizations & group practices 1

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": "1518739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1508366584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2614 GAGE AVE",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "90255",
            "telephone_number": "323-282-2811",
            "fax_number": "323-588-1124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 SKYPARK DR STE 115",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055331",
            "telephone_number": "424-407-3303",
            "fax_number": "424-407-3309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31461 Rancho Viejo Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "San Juan Capistrano",
            "state": "CA",
            "postal_code": "926751865",
            "country_code": "US",
            "telephone_number": "424-407-3303",
            "fax_number": "424-407-3309",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2424 SE Bristol St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Newport Beach",
            "state": "CA",
            "postal_code": "926600757",
            "country_code": "US",
            "telephone_number": "424-407-3303",
            "fax_number": "424-407-3303",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10801 National Blvd Ste 430",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900644139",
            "country_code": "US",
            "telephone_number": "424-407-3303",
            "fax_number": "424-407-3309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCARTIN",
        "first_name": "KALIE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-16",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33875TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KALIE",
            "last_name": "BAKER",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.