Individual provider Active NPI

Kristin Uchizono, O.D.

  • Optometrist
  • Huntington Beach, CA
National Provider Identifier
1689125502
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
33599 Issued in CA
Practice address
16450 Bolsa Chica St
Huntington Beach, CA 92649-2603
Phone
(714) 840-1366
NPI assigned
Oct 14, 2016
Last updated
Oct 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 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 33599 CA Primary

Addresses

Primary practice location

16450 Bolsa Chica St
Huntington Beach, CA 92649-2603

Mailing address

18151 Palmetto Cir
Fountain Valley, CA 92708-5752

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
I20241105002554 CA Practitioner - Optometry 1759815384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Walter Yim OD a Professional CorporationGroup PAC ID 7517196249, 3 clinicians

Practice addresses (Care Compare)

16450 Bolsa Chica St
Huntington Beach, CA 92649-2603
Phone (714) 840-1366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33599CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Walter Yim OD a Professional Corporation Optometrist CurrentSince Nov 6, 2024 Accepting new patients
Timothy C. Jankowski, OD, Inc Optometrist PastSince Oct 27, 2024 Accepting new patients

Locations

16450 Bolsa Chica St
Huntington Beach, CA 92649
Phone (714) 840-1366

Organizations & group practices 2

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": "1476403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1689125502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18151 PALMETTO CIR",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16450 BOLSA CHICA ST",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926492603",
            "telephone_number": "714-840-1366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UCHIZONO",
        "first_name": "KRISTIN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-14",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.