Individual provider Active NPI

Ernest K Takahashi, OD

  • Optometrist
  • Sacramento, CA
National Provider Identifier
1811055007
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5054T Issued in CA
Practice address
400 O St Ste 102
Sacramento, CA 95814-5327
Phone
(916) 443-3524
Fax
(916) 443-3986
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5054T CA Primary

Addresses

Primary practice location

400 O St Ste 102
Sacramento, CA 95814-5327

Mailing address

400 O St Ste 102
Sacramento, CA 95814-5327
Phone (916) 443-3524

Other identifiers 1

IdentifierTypeStateIssuer
SD0050540MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5054TCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213920000000",
    "number": "1811055007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 O ST STE 102",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958145327",
            "telephone_number": "916-443-3524",
            "fax_number": "916-443-3986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 O ST STE 102",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958145327",
            "telephone_number": "916-443-3524",
            "fax_number": "916-443-3986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKAHASHI",
        "first_name": "ERNEST",
        "middle_name": "K",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2008-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5054T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0050540",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.