Anita Koo, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

33430 Issued in CA

Practice address

1520 E Plaza Blvd
National City, CA 91950-3616

Phone

(619) 425-7755

Fax

(619) 425-2138

NPI assigned

Jul 14, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, TX2 enrollments

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 2

Specialty

Optometry

Education

Southern California College of Optometry, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centro de Salud de la Comunidad de San Ysidro,Inc. 291 clinicians

California Retina Associates, LP 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles (9 of 10)

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: akarmenkoo33099@syhealth.direct-ci.com
• Direct secure messaging: akoo@retinadrs.intellechartdirect.net

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.

• California Retina Associates, LP

  • Ophthalmology Physician
  • Chula Vista, CA
  • NPI 1114033404

  CA

  Medicare reassignment Care Compare group NPD
• Centro de Salud de la Comunidad de San Ysidro, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1124782685

  CA

  Medicare reassignment NPD
• Eye Physicians Medical Surgical Center

  • Eyewear Supplier
  • Chula Vista, CA
  • NPI 1538135694

  CA

  Medicare reassignment NPD
• Southern Indian Health Council

  • Health Service Clinic/Center
  • Campo, CA
  • NPI 1922090885

  TX

  Medicare reassignment NPD
• Centro de Salud de la Comunidad de San Ysidro Inc

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1457033813
  NPD
• Centro de Salud de la Comunidad de San Ysidro, Inc.

  • Federally Qualified Health Center (FQHC)
  • National City, CA
  • NPI 1003869363
  NPD
• Southern Indian Health Council

  • Clinic/Center
  • Alpine, CA
  • NPI 1346247947
  NPD
• Southern Indian Health Council

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Boulevard, CA
  • NPI 1902562416
  NPD
• Operation Samahan, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1194616268
  NPD (past)

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1669825667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 BIERNACKI CT",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919116702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 E PLAZA BLVD",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919503616",
            "telephone_number": "619-425-7755",
            "fax_number": "619-425-2138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOO",
        "first_name": "ANITA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-14",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyung Chul Kim, M.D.
• Justin Benard King, MD
• Kellyann Knight, CRNP
• Jennifer Knisely, PMHNP-BC
• Latania Knox
• Nathaniel Benjamin Kopka, BT
• Allison Kornblatt, M.D.
• Zoe Rebecca Kornweibel, CPSS
• Carolyn F. Kreider
• Annette Kruger

• All providers in National City, CA
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.