Individual provider Active NPI

Karen Lee Santillan, O.D.

  • Optometrist
  • Bellflower, CA
National Provider Identifier
1780627422
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12606T Issued in CA
Practice address
16816 Clark Ave
Bellflower, CA 90706-5702
Phone
(562) 925-6591
NPI assigned
Jun 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12606T CA Primary

Addresses

Primary practice location

16816 Clark Ave
Bellflower, CA 90706-5702

Mailing address

16816 Clark Ave
Bellflower, CA 90706-5702
Phone (562) 925-6591

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20061019000643 CA Practitioner - Optometry 6204832959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9333 Rosecrans Ave
Bellflower, CA 90706-2141
Phone (562) 461-3000

9400 Rosecrans Ave
Bellflower, CA 90706-2246
Phone (562) 461-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12606TCAMDOptometrist
12606CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Amplify Medical PC Optometrist CurrentSince Jan 1, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 28, 2009 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 28, 2009 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Optometric Vision Care Associates Inc Optometrist PastSince Dec 21, 2021 Accepting new patients

Locations

16816 Clark Ave
Bellflower, CA 90706
Phone (310) 925-6591

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3340

9333 Imperial Hwy
Downey, CA 90242
Phone (562) 657-8850

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1780627422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16816 CLARK AVE",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907065702",
            "telephone_number": "562-925-6591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16816 CLARK AVE",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907065702",
            "telephone_number": "562-925-6591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTILLAN",
        "first_name": "KAREN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12606T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9333 Imperial Hwy",
            "city": "Downey",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902422812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bellflower, CA

Sources for this page

Verify at the official NPI Registry.