Individual provider Active NPI

Katherine A Aquino, O.D.

  • Optometrist
  • Burlingame, CA
National Provider Identifier
1770639825
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11459T Issued in CA
Practice address
1750 El Camino Real
Suite 103
Burlingame, CA 94010-3228
Phone
(650) 692-2020
Fax
(650) 692-1441
NPI assigned
Jan 25, 2007
Last updated
Jul 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 11459T CA Primary

Addresses

Primary practice location

1750 El Camino Real
Suite 103
Burlingame, CA 94010-3228

Mailing address

900 S Eliseo Dr
Ste 102
Greenbrae, CA 94904-2152
Phone (415) 461-8200

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
I20200925000728 CA Practitioner - Optometry 6406275379 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11459TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Peninsula Eye Physicians & Surgeons Medical Group CurrentSince Oct 1, 2023 Accepting new patients
Robert R. Anderson M.D., Inc. CurrentSince Jul 21, 2020 Accepting new patients
Alla Skalnyi M.D. Inc. a Professional Corporation PastSince Jul 17, 2022 Accepting new patients
Pacific Eye Specialists Optometrist PastSince Oct 1, 2023 Accepting new patients
Robert R. Elliston, M.D. Past Accepting new patients

Locations

900 S Eliseo Dr
Ste 102
Greenbrae, CA 94904
Phone (415) 461-8200

50 S San Mateo Dr
Ste 200
San Mateo, CA 94401
Phone (650) 342-4595

Interoperability endpoints

  • Direct secure messaging: kaquino345139@hisp.ehr.sutterhealth.org

Organizations & group practices 5

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1770639825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S ELISEO DR",
            "address_2": "STE 102",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042152",
            "telephone_number": "415-461-8200",
            "fax_number": "415-461-4627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 EL CAMINO REAL",
            "address_2": "SUITE 103",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103228",
            "telephone_number": "650-692-2020",
            "fax_number": "650-692-1441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AQUINO",
        "first_name": "KATHERINE",
        "middle_name": "A",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11459T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlingame, CA

Sources for this page

Verify at the official NPI Registry.