Individual provider Active NPI

Kaaryn Pederson Vanbuskirk, O.D.

  • Optometrist
  • Sacramento, CA
National Provider Identifier
1760466775
Registry record updated May 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT1205T Issued in CA
Practice address
4860 Y St
Suite 2400
Sacramento, CA 95817-2307
Phone
(916) 734-7851
Fax
(916) 734-6197
NPI assigned
Dec 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT1205T CA Primary

Addresses

Primary practice location

4860 Y St
Suite 2400
Sacramento, CA 95817-2307

Mailing address

4860 Y St
Suite 2400
Sacramento, CA 95817-2307
Phone (916) 734-7851

Other names 1

  • Mrs. Kaaryn Van Buskirk Other name

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
I20090112000023 CA Practitioner - Optometry 5799848156 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of CaliforniaGroup PAC ID 8022922475, 562 clinicians

Practice addresses (Care Compare)

14264 Innovation Dr
Folsom, CA 95630-4099
Phone (916) 985-9300

2261 Douglas Blvd
Roseville, CA 95661-3831
Phone (916) 783-7109

2400 Del Paso Rd
Suite 145
Sacramento, CA 95834-9629
Phone (916) 928-3940

271 Turnpike Dr
Folsom, CA 95630-8098
Phone (916) 985-9200

4860 Y St
Sacramento, CA 95817-2307

Hospital & facility affiliations

  • University of California Davis Medical Center Hospital, Sacramento, CA, CCN 050599

Merit-based Incentive Payment System (MIPS)

Final score
90.11 of 100Reported as group
Quality
86.24
Promoting interoperability
100
Improvement activities
40
Cost
78.35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT1205TCAMDOptometrist
12059CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Oct 1, 2021 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the University of California CurrentSince Oct 1, 2021 Accepting new patients
Regents of the Univ of Ca CurrentSince Nov 16, 1999 Accepting new patients
Regents of the Univ of Ca Optometrist CurrentSince Nov 16, 1999 Accepting new patients
Regents of the University of California Current Accepting new patients
Essent PRMC LP Past Accepting new patients

Locations

14264 Innovation Dr
Folsom, CA 95630
Phone (916) 703-2486

1620 E Roseville Pkwy
Ste 200
Roseville, CA 95661
Phone (916) 771-0251

2261 Douglas Blvd
Roseville, CA 95661
Phone (916) 783-1044

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

77 Cadillac Dr
Ste 101
Sacramento, CA 95825
Phone (916) 286-6162

4860 Y St
Ste 2400
Sacramento, CA 95817
Phone (916) 734-6602

2400 Del Paso Rd
Ste 145
Sacramento, CA 95834
Phone (916) 928-3940

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

4860 Y St
Ste 200
Sacramento, CA 95817
Phone (916) 734-3761

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399507200000",
    "number": "1760466775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4860 Y ST",
            "address_2": "SUITE 2400",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172307",
            "telephone_number": "916-734-7851",
            "fax_number": "916-734-6197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4860 Y ST",
            "address_2": "SUITE 2400",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172307",
            "telephone_number": "916-734-7851",
            "fax_number": "916-734-6197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANBUSKIRK",
        "first_name": "KAARYN",
        "middle_name": "PEDERSON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-02",
        "last_updated": "2014-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT1205T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAARYN",
            "last_name": "VAN BUSKIRK",
            "prefix": "MRS.",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.