Active NPI
Katherine A Aquino, O.D.
- Optometrist
- Burlingame, CA
National Provider Identifier
1770639825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 11459T
- 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, 2020
- Sex
- Female
- Sole proprietor
- No
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 | 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11459T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid Peninsula Eye Physicians & Surgeons Medical Group | Current | Accepting new patients | |
| Robert R. Anderson M.D., Inc. | Current | Accepting new patients | |
| Alla Skalnyi M.D. Inc. a Professional Corporation | Past | Accepting new patients | |
| Pacific Eye Specialists | Optometrist | Past | 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
- 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.
-
dba Pacific Eye Specialists
- Ophthalmology Physician
- San Mateo, CA
- NPI 1407924889
-
- Ophthalmology Physician
- Greenbrae, CA
- NPI 1962695304
-
- Specialist
- Burlingame, CA
- NPI 1093088106
-
- Optometrist
- San Mateo, CA
- NPI 1679690150
-
- Ophthalmology Physician
- Burlingame, CA
- NPI 1831244938
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; 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.