Individual provider Active NPI

Anna Margarita Animo Geronimo, O.D.

  • Optometrist
  • San Leandro, CA
National Provider Identifier
1518977933
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11421T Issued in CA
Practice address
15251 E 14TH St
Suite B
San Leandro, CA 94578-1905
Phone
(510) 481-2121
NPI assigned
Aug 8, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11421T CA Primary

Addresses

Primary practice location

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

Mailing address

15251 E 14TH St
Suite B
San Leandro, CA 94578-1905
Phone (510) 481-2121

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
I20081024000460 CA Practitioner - Optometry 0446249932 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2500 El Camino Real
Suite 100
Palo Alto, CA 94306-1723
Phone (650) 858-0202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11421CAMDClinical Neuropsychologist
11421TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vista Center for the Blind and Visually Impaired CurrentSince Jul 11, 2001 Accepting new patients
Richard Wu, O.D., a Professional Corporation Optometrist CurrentSince Oct 1, 2024 Accepting new patients
Vista Center for the Blind and Visually Impaired CurrentSince Jul 11, 2001 Accepting new patients
Vista Center for the Blind and Visually Impaired PastSince Jul 11, 2001 Accepting new patients

Locations

35219 Newark Blvd
Ste B
Newark, CA 94560

2500 El Camino Real
Ste 100
Palo Alto, CA 94306
Phone (650) 858-0202

4299 Rosewood Dr
Unit 105
Pleasanton, CA 94588
Phone (925) 416-1888

14895 E 14th St
Ste 340
San Leandro, CA 94578
Phone (510) 481-2121

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

7129 NE Imbrie Dr
Hillsboro, OR 97124
Phone (503) 690-2020

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.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518977933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15251 E 14TH ST",
            "address_2": "SUITE B",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945781905",
            "telephone_number": "510-481-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15251 E 14TH ST",
            "address_2": "SUITE B",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945781905",
            "telephone_number": "510-481-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERONIMO",
        "first_name": "ANNA MARGARITA",
        "middle_name": "ANIMO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11421T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

Verify at the official NPI Registry.