Individual provider Active NPI

Danita Tom, MD

  • Ophthalmology Physician
  • Orange, CA
National Provider Identifier
1538349196
Registry record updated Nov 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A99289 Issued in CA
Practice address
101 The City Dr S
Dept of Ophthalmology
Orange, CA 92868-3201
Phone
(949) 824-0158
Fax
(949) 824-4015
NPI assigned
Nov 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2007

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 A99289 CA Primary

Addresses

Primary practice location

101 The City Dr S
Dept of Ophthalmology
Orange, CA 92868-3201

Mailing address

101 The City Dr S
Dept of Ophthalmology
Orange, CA 92868-3201
Phone (949) 824-0158

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150820011859 OR Practitioner - Ophthalmology 8426197211 Reassigns benefits to 1 organization
I20150928000507 WA Practitioner - Ophthalmology 8426197211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Wisconsin School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the NorthwestGroup PAC ID 5799688230, 1,805 clinicians

Practice addresses (Care Compare)

3600 N Interstate Ave
Portland, OR 97227-1106
Phone (800) 813-2000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A99289CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest Ophthalmology CurrentSince Jul 11, 2015 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Ophthalmology CurrentSince Jul 11, 2015 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jul 11, 2015 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

3600 N Interstate Ave
Ofc
Portland, OR 97227
Phone (503) 285-9321

3600 N Interstate Ave
Portland, OR 97227
Phone (503) 285-9321

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 3

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": "1194739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194739200000",
    "number": "1538349196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "address_2": "DEPT OF OPHTHALMOLOGY",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "949-824-0158",
            "fax_number": "949-824-4015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "address_2": "DEPT OF OPHTHALMOLOGY",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "949-824-0158",
            "fax_number": "949-824-4015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOM",
        "first_name": "DANITA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-11",
        "last_updated": "2007-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A99289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.