Individual provider Active NPI

Ka Yee So, OD

  • Optometrist
  • Oakland, CA
National Provider Identifier
1770008609
Registry record updated May 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
33775TLG Issued in CA
Practice address
286 E 10TH St
Oakland, CA 94606-2859
Phone
(510) 879-1568
NPI assigned
Aug 11, 2017
Last updated
May 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 33775TLG CA Primary

Addresses

Primary practice location

286 E 10TH St
Oakland, CA 94606-2859

Mailing address

3140 Ellis St Apt 4
Berkeley, CA 94703-2443
Phone (510) 847-9524

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
I20170927001598 CA Practitioner - Optometry 2961776158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Bay OphthalmologyGroup PAC ID 3274621578, 4 clinicians

Practice addresses (Care Compare)

1289 Pinole Valley Rd
Pinole, CA 94564-1348
Phone (510) 724-1768

Merit-based Incentive Payment System (MIPS)

Final score
94.13 of 100Reported as group
Quality
100
Improvement activities
40
Cost
74.03

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33775TLGCAMDOptometrist
33775CAMDLicensed Psychiatric Technician

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica de la Raza Inc Current Accepting new patients
East Bay Ophthalmology CurrentSince Jan 19, 2021 Accepting new patients

Locations

1289 Pinole Valley Rd
Pinole, CA 94564
Phone (510) 724-1768

Organizations & group practices 2

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": "1502409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1770008609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3140 ELLIS ST APT 4",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947032443",
            "telephone_number": "510-847-9524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 E 10TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946062859",
            "telephone_number": "510-879-1568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SO",
        "first_name": "KA YEE",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-11",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33775TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.