Individual provider Active NPI

Kanako Margaret Tomita, O.D.

  • Optometrist
  • Folsom, CA
National Provider Identifier
1811972276
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10174T Issued in CA
Practice address
1115 E Bidwell St
Suite 124
Folsom, CA 95630-5554
Phone
(916) 983-1066
NPI assigned
Dec 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10174T CA Primary

Addresses

Primary practice location

1115 E Bidwell St
Suite 124
Folsom, CA 95630-5554

Mailing address

421 Blue Ravine Rd
Ste 300
Folsom, CA 95630-3821
Phone (916) 983-1066

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The 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
I20121203000557 CA Practitioner - Optometry 1052563756 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10174CAMDProfessional Counselor
10174TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc CurrentSince Oct 10, 2012 Accepting new patients
Permanente Medical Group Inc Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Oct 10, 2012 Accepting new patients
Sutter North Medical Foundation Past Accepting new patients
Folsom Optometry Center Optometrist Past Accepting new patients

Locations

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

1011 Riverside Ave
Roseville, CA 95678
Phone (916) 746-4578

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

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": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1811972276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 BLUE RAVINE RD",
            "address_2": "STE 300",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303821",
            "telephone_number": "916-983-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 E BIDWELL ST",
            "address_2": "SUITE 124",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956305554",
            "telephone_number": "916-983-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMITA",
        "first_name": "KANAKO",
        "middle_name": "MARGARET",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-08",
        "last_updated": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10174T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1011 Riverside Ave",
            "city": "Roseville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956785134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

Verify at the official NPI Registry.