Individual provider Active NPI

Karin Kaori Miyazaki, O.D.

  • Optometrist
  • Cupertino, CA
National Provider Identifier
1598996316
Registry record updated Dec 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13735 Issued in CA
Practice address
19998 Homestead Rd Ste E
Cupertino, CA 95014-0569
Phone
(408) 257-5262
NPI assigned
Jul 28, 2009
Last updated
Dec 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13735 CA Primary

Addresses

Primary practice location

19998 Homestead Rd Ste E
Cupertino, CA 95014-0569

Mailing address

605 Marathon Dr
Campbell, CA 95008-0455

Other practice location 1

2720 E Palmdale Blvd
Suite Number 133
Palmdale, CA 93550-4930
Phone (661) 267-0026

Other practice location 2

2720 E Palmdale Blvd
Suite Number 133
Palmdale, CA 93550-4930
Phone (661) 267-0026

Other practice location 3

5710 Cahalan Ave Ste 5B
San Jose, CA 95123-3010
Phone (408) 225-5935

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Keith Kosakura, O.D. PastSince Dec 15, 2019 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, 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": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576195200000",
    "number": "1598996316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 MARATHON DR",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950080455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19998 HOMESTEAD RD STE E",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950140569",
            "telephone_number": "408-257-5262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2720 E Palmdale Blvd",
            "address_2": "Suite Number 133",
            "address_purpose": "LOCATION",
            "city": "Palmdale",
            "state": "CA",
            "postal_code": "935504930",
            "country_code": "US",
            "telephone_number": "661-267-0026",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2720 E Palmdale Blvd",
            "address_2": "Suite Number 133",
            "address_purpose": "LOCATION",
            "city": "Palmdale",
            "state": "CA",
            "postal_code": "935504930",
            "country_code": "US",
            "telephone_number": "661-267-0026",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5710 Cahalan Ave Ste 5B",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951233010",
            "country_code": "US",
            "telephone_number": "408-225-5935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIYAZAKI",
        "first_name": "KARIN",
        "middle_name": "KAORI",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-28",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cupertino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; 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.