Active NPI
Kimberly A Tom, O.D.
- Optometrist
- San Francisco, CA
National Provider Identifier
1740356567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 9718T
- Practice address
- 4017 24TH St
San Francisco, CA 94114-3715 - Phone
- (415) 821-3937
- Fax
- (415) 821-5896
- NPI assigned
- Nov 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 9718T | CA | Primary |
Addresses
Primary practice location
4017 24TH St
San Francisco, CA 94114-3715
Mailing address
4017 24TH St
San Francisco, CA 94114-3715
Phone (415) 821-3937
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170719001752 | CA | Practitioner - Optometry | 6103196480 | Practice locations: San Francisco, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9718T | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740356567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4017 24TH ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941143715",
"telephone_number": "415-821-3937",
"fax_number": "415-821-5896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4017 24TH ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941143715",
"telephone_number": "415-821-3937",
"fax_number": "415-821-5896"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOM",
"first_name": "KIMBERLY",
"middle_name": "A",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "9718T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.