Individual provider Active NPI

Eric J Kawata, O.D.

  • Optometrist
  • Laguna Niguel, CA
National Provider Identifier
1689708778
Registry record updated Jul 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
08259T Issued in CA
Practice address
30231 Golden Lantern
Suite B
Laguna Niguel, CA 92677-5989
Phone
(949) 495-9336
Fax
(949) 495-9364
NPI assigned
Mar 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 08259T CA Primary

Addresses

Primary practice location

30231 Golden Lantern
Suite B
Laguna Niguel, CA 92677-5989

Mailing address

30231 Golden Lantern
Suite B
Laguna Niguel, CA 92677-5989
Phone (949) 495-9336

Other identifiers 1

IdentifierTypeStateIssuer
AN317YOtherCAPTAN

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
I20081001000169 CA Practitioner - Optometry 5698843803 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1985
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

101 E Lincoln Ave
Suite 103
Anaheim, CA 92805-3203
Phone (714) 535-7515

30231 Golden Lantern
Suite B
Laguna Niguel, CA 92677-5989
Phone (949) 495-9336

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08259TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eric J Kawata O D Inc Optometrist CurrentSince May 6, 2007 Accepting new patients
Veronica Chu OD Professional Corporation Optometrist PastSince May 5, 2008 Accepting new patients

Locations

101 E Lincoln Ave
Ste 103
Anaheim, CA 92805
Phone (714) 535-7515

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311552000000",
    "number": "1689708778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30231 GOLDEN LANTERN",
            "address_2": "SUITE B",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926775989",
            "telephone_number": "949-495-9336",
            "fax_number": "949-495-9364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30231 GOLDEN LANTERN",
            "address_2": "SUITE B",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926775989",
            "telephone_number": "949-495-9336",
            "fax_number": "949-495-9364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAWATA",
        "first_name": "ERIC",
        "middle_name": "J",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2011-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "08259T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "AN317Y",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Niguel, CA

Sources for this page

Verify at the official NPI Registry.