Randy Taketa, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT9103TPA Issued in CA

Practice address

2901 Wilshire Blvd
Suite 100
Santa Monica, CA 90403-4901

Phone

(310) 829-0055

Fax

(310) 453-2971

NPI assigned

Dec 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Silver OD PC and Taketa OD PC a Partnership of Opt CorpGroup PAC ID 6204722762, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Silver OD PC & Taketa OD PC a Partnership of Opt Corp

  • Optometrist
  • Santa Monica, CA
  • NPI 1114948866
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300320000000",
    "number": "1881679587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 WILSHIRE BLVD",
            "address_2": "SUITE 100",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034901",
            "telephone_number": "310-829-0055",
            "fax_number": "310-453-2971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 WILSHIRE BLVD",
            "address_2": "SUITE 100",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034901",
            "telephone_number": "310-829-0055",
            "fax_number": "310-453-2971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKETA",
        "first_name": "RANDY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2011-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT9103TPA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharwin Tafazoli, MD
• David Joel Taft, D.D.S.
• Teri Taft, LCSW
• Hanna D Tagle, NURSE PRACTITIONER
• Yuki Takasumi, M.D.
• Noa Tal, MD
• Efrain Talamantes, M.D.
• Oscar Talamantes, L.AC.
• Amir Hossein Talebi Liasi, M.D.
• Talk to Michele Family Therapy, a Professional Corporation

• Optometrist in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.