Individual provider Active NPI

Sarah Ito, O.D.

  • Optometrist
  • Santa Monica, CA
National Provider Identifier
1740271832
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10084T Issued in CA
Practice address
2605 Lincoln Boulevard
Santa Monica, CA 90405-4619
Phone
(310) 452-1039
Fax
(855) 450-1039
NPI assigned
Oct 29, 2005
Last updated
Feb 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10084T CA Primary

Addresses

Primary practice location

2605 Lincoln Boulevard
Santa Monica, CA 90405-4619

Mailing address

2605 Lincoln Boulevard
Santa Monica, CA 90405-4619
Phone (310) 452-1039

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
I20090514000160 CA Practitioner - Optometry 0648329060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Sarah K Ito O D a Professional CorporationGroup PAC ID 0547290603, 2 clinicians

Practice addresses (Care Compare)

1731 Ocean Park Blvd
Santa Monica, CA 90405-4901
Phone (310) 452-1039

2605 Lincoln Blvd
Santa Monica, CA 90405-4619

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10084CAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Sarah K Ito O D a Professional Corporation Optometrist CurrentSince Dec 16, 2002 Accepting new patients

Locations

1731 Ocean Park Blvd
Santa Monica, CA 90405
Phone (310) 452-1039

2605 Lincoln Blvd
Santa Monica, CA 90405
Phone (310) 452-1039

Organizations & group practices 1

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": "1130544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1740271832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 LINCOLN BOULEVARD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904054619",
            "telephone_number": "310-452-1039",
            "fax_number": "855-450-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 LINCOLN BOULEVARD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904054619",
            "telephone_number": "310-452-1039",
            "fax_number": "855-450-1039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITO",
        "first_name": "SARAH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-29",
        "last_updated": "2022-02-04",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10084T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.