Individual provider Active NPI

Kristen Glasgow, O.D.

  • Optometrist
  • Santa Rosa, CA
National Provider Identifier
1699047530
Registry record updated Dec 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
33833TLG Issued in CA
Practice address
2320 Midway Dr
Santa Rosa, CA 95405
Phone
(707) 526-2020
NPI assigned
Feb 8, 2012
Last updated
Dec 21, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 33833TLG CA Primary

Addresses

Primary practice location

2320 Midway Dr
Santa Rosa, CA 95405

Mailing address

3247 Solano Ave
Napa, CA 94558-3255
Phone (704) 222-6302

Other practice location 1

2320 Midway Dr
Santa Rosa, CA 95405
Phone (707) 526-2020

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
I20180216001946 CA Practitioner - Optometry 7911164645 Reassigns benefits to 2 organizations
Practice locations: Santa Rosa, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Napa Valley Optometric GRP a Prof CorpGroup PAC ID 5890742399, 4 clinicians

Practice addresses (Care Compare)

1104 Pear Tree Lane
Napa, CA 94558-6446

1104 Pear Tree LN
Napa, CA 94558-6446
Phone (707) 252-5380

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33833CAMDMarriage & Family Therapist
33833TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Napa Valley Optometric Group Optometrist CurrentSince Jan 1, 2019 Accepting new patients
Tiffany Moore, O.D. Inc, a Professional Optometric Corporation Optometrist CurrentSince Dec 11, 2023 Accepting new patients
Visioncare of California Inc. Optometrist Past Accepting new patients
Marquee Eyecare Centers Inc PastSince Mar 24, 2025 Accepting new patients

Locations

1104 Pear Tree Ln
Napa, CA 94558
Phone (707) 252-5380

1265 N Dutton Ave
Santa Rosa, CA 95401
Phone (707) 526-2027

Interoperability endpoints

  • Direct secure messaging: kglasgow709957@direct.ochin.org

Organizations & group practices 4

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": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545350400000",
    "number": "1699047530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3247 SOLANO AVE",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945583255",
            "telephone_number": "704-222-6302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 MIDWAY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95405",
            "telephone_number": "707-526-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2320 Midway Dr",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "95405",
            "country_code": "US",
            "telephone_number": "707-526-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLASGOW",
        "first_name": "KRISTEN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-08",
        "last_updated": "2018-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33833TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.