Individual provider Active NPI

Henry E Kikunaga, O.D.

  • Corneal and Contact Management Optometrist
  • Bonita, CA
National Provider Identifier
1841406394
Registry record updated Apr 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
13186 Issued in CA
Practice address
180 Otay Lakes Rd
Suite 201
Bonita, CA 91902-2400
Phone
(619) 267-9900
Fax
(619) 267-9910
NPI assigned
May 14, 2007
Last updated
Apr 1, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 13186 CA Primary

Addresses

Primary practice location

180 Otay Lakes Rd
Suite 201
Bonita, CA 91902-2400

Mailing address

180 Otay Lakes Rd
Suite 201
Bonita, CA 91902-2400
Phone (619) 267-9900

Other identifiers 1

IdentifierTypeStateIssuer
1841406394MedicaidCA

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
I20080530000588 CA Practitioner - Optometry 4981663804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Vision PCGroup PAC ID 9234472242, 115 clinicians

Practice addresses (Care Compare)

11717 Bernardo Plaza CT
Suite 105
San Diego, CA 92128-2419
Phone (858) 487-5555

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Total Vision PC CurrentSince Apr 22, 2019 Accepting new patients
Choice Vision Optometry, Inc Corneal and Contact Management PastSince Dec 1, 2007 Accepting new patients
John C Pack, O.D. and Beverly Bianes, O.D. Inc PastSince Mar 1, 2007 Accepting new patients
Mira Mesa Optometry, Inc PastSince Mar 28, 2018 Accepting new patients
Steven T Klein OD & Kimberly Plattner OD a Professional Corporation Past Accepting new patients

Locations

180 Otay Lakes Rd
Bonita, CA 91902
Phone (619) 267-9900

180 Otay Lakes Rd
Ste 201
Bonita, CA 91902
Phone (619) 267-2012

374 E H St
Chula Vista, CA 91910
Phone (619) 425-7990

890 Eastlake Pkwy
Ste 102
Chula Vista, CA 91914
Phone (619) 216-3937

7090 Parkway Dr
Ste A
La Mesa, CA 91942
Phone (619) 460-2020

7850 Broadway
Lemon Grove, CA 91945
Phone (619) 697-2020

27271 Las Ramblas
Ste 210
Mission Viejo, CA 92691

11717 Bernardo Plaza Ct
Ste 105
San Diego, CA 92128
Phone (858) 487-5555

12880 Carmel Country Rd
Ste D110
San Diego, CA 92130
Phone (858) 289-4820

8230 Mira Mesa Blvd
Ste B
San Diego, CA 92126
Phone (858) 566-6670

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": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364774400000",
    "number": "1841406394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 OTAY LAKES RD",
            "address_2": "SUITE 201",
            "city": "BONITA",
            "state": "CA",
            "postal_code": "919022400",
            "telephone_number": "619-267-9900",
            "fax_number": "619-267-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 OTAY LAKES RD",
            "address_2": "SUITE 201",
            "city": "BONITA",
            "state": "CA",
            "postal_code": "919022400",
            "telephone_number": "619-267-9900",
            "fax_number": "619-267-9910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIKUNAGA",
        "first_name": "HENRY",
        "middle_name": "E",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2013-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "13186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841406394",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita, CA

Sources for this page

Verify at the official NPI Registry.