Nisreen Mesiwala Kothari, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

A144488 Issued in CA

Practice address

15051 Hesperian Blvd Ste a
San Leandro, CA 94578

Phone

(510) 276-1212

NPI assigned

Apr 4, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

University of Michigan Medical School, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Specialties Medical Group Inc.Group PAC ID 1557756251, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Eden Medical Center Hospital, Castro Valley, CA, CCN 050488

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: nkothari366896@hisp.ehr.sutterhealth.org

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.

• Eye Specialties Medical Group Inc.

  • Ophthalmology Physician
  • Castro Valley, CA
  • NPI 1568030260
  Medicare reassignment Care Compare group NPD
• Alta Bates Summit Medical Center

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Oakland, CA
  • NPI 1043358542
  NPD (past)
• California Pacific Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Oakland, CA
  • NPI 1275002453
  NPD (past)
• Eden Medical Center/San Leandro Hospital Campus

  • Rehabilitation Hospital Unit
  • San Leandro, CA
  • NPI 1679523633
  NPD (past)
• Hill Physicians Medical Group - PPO Program

  • Preferred Provider Organization
  • San Ramon, CA
  • NPI 1679011035
  NPD (past)
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Burlingame, CA
  • NPI 1043670334
  NPD (past)
• Tufts Medical Center, Inc.

  • Psychiatric Hospital Unit
  • Boston, MA
  • NPI 1053350306
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Castro Valley, CA
  • NPI 1063812907
  Care Compare affiliation

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

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532304000000",
    "number": "1730445644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 KING ST UNIT 432",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941075488",
            "telephone_number": "248-760-9236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15051 HESPERIAN BLVD STE A",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "94578",
            "telephone_number": "510-276-1212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1899 W March Ln",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952076402",
            "country_code": "US",
            "telephone_number": "209-623-4700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1899 W March Ln",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952076402",
            "country_code": "US",
            "telephone_number": "209-623-4700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "162 Clinton St",
            "address_purpose": "LOCATION",
            "city": "Redwood City",
            "state": "CA",
            "postal_code": "940621552",
            "country_code": "US",
            "telephone_number": "650-369-2529",
            "fax_number": "650-369-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOTHARI",
        "first_name": "NISREEN",
        "middle_name": "MESIWALA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-04",
        "last_updated": "2018-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NM",
            "license": "RS2014-0672",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "262309",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "0",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A144488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Kopelnik, M.D.
• Miriam Kopf
• Koiffi Korha
• Hanna Korynta
• Angelica Koskov
• Alexandria Marie Kotran
• Arielle Kovacs
• Bradford Burr Kraetzer, M.D.
• Jerrold Kram, M.D.
• Johanna Kramer

• Ophthalmology Physician in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2018; 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.