Kathleen Marie Andersen, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

8187T Issued in CA

Practice address

22312 El Paseo
Suite D
Rancho Santa Margarita, CA 92688-5806

Phone

(949) 589-6171

Fax

(949) 589-0657

NPI assigned

Jan 19, 2007

Last updated

Dec 5, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Southern California College of Optometry, 1985

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://kandersenod.ef.prod.fhir.ema-api.com/fhir/r4/

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.

• Kathleen M. Andersen, O.D., Inc.

  • Optometrist
  • Rancho Santa Margarita, CA
  • NPI 1043439821
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354665600000",
    "number": "1881747962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22312 EL PASEO",
            "address_2": "SUITE D",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926885806",
            "telephone_number": "949-589-6171",
            "fax_number": "949-589-0657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22312 EL PASEO",
            "address_2": "SUITE D",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926885806",
            "telephone_number": "949-589-6171",
            "fax_number": "949-589-0657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2012-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8187T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Allen, OTR/L
• Allison a Holtkamp, PSYD Psychologist Inc (na)
• Sarah Jane Pingol Alvidera
• Amp Sports Med Inc
• Anaheim Urgent Care, Inc (UrgentMED- Rancho Santa Margarita)
• Andrea C. Huyn, OD, Inc
• Barbara E Andres, DC
• Andrew Lee D.D.S., Inc (El Paseo Dental Center)
• Tara Marie Anguiano, D.C.
• Aaron Ann

• Optometrist in Rancho Santa Margarita, CA
• Providers in Rancho Santa Margarita, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; 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.