Individual provider Active NPI

Kristine Michi Kobayashi, O.D.

  • Optometrist
  • Whittier, CA
National Provider Identifier
1922095439
Registry record updated Oct 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9444 Issued in CA
Practice address
11245 Washington Blvd
Whittier, CA 90606-3111
Phone
(562) 692-1208
Fax
(626) 856-0570
NPI assigned
Sep 29, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9444 CA Primary

Addresses

Primary practice location

11245 Washington Blvd
Whittier, CA 90606-3111

Mailing address

4266 Lincoln Blvd
Marina del Rey, CA 90292-5618
Phone (310) 823-4595

Other identifiers 1

IdentifierTypeStateIssuer
SD0094440MedicaidCA

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
I20120201000745 CA Practitioner - Optometry 9638336779 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1990
Medicare assignment
May accept Medicare assignment
Group practices
Golden Ardaya and Lin Optometry IncGroup PAC ID 2961667399, 18 clinicians
Monarch Bay Optometry, Inc.Group PAC ID 5193152510, 3 clinicians
Kobayashi Optometric IncGroup PAC ID 7012174030, 2 clinicians

Practice addresses (Care Compare)

11245 Washington Blvd
Whittier, CA 90606-3111
Phone (562) 692-1208

32932 Pacific Coast Hwy
Suite 13
Dana Point, CA 92629-3467
Phone (949) 487-3937

4266 Lincoln Blvd
Marina del Rey, CA 90292-5618
Phone (310) 823-4595

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9444CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Ardaya & Lin Optometry Inc Optometrist CurrentSince Oct 22, 2023 Accepting new patients
Monarch Bay Optometry, Inc. Optometrist CurrentSince Oct 1, 2019 Accepting new patients
Kobayashi Optometric Inc Optometrist CurrentSince Nov 1, 2011 Accepting new patients
Dr. Irene M. Lin-Dilorinzo, O.D., Inc. Optometrist CurrentSince Oct 1, 2019 Accepting new patients
Sheldon M. Golden OD Optometric Corporation Optometrist Past Accepting new patients

Locations

32932 Pacific Coast Hwy
Ste 13
Dana Point, CA 92629
Phone (949) 487-3937

4266 Lincoln Blvd
Marina del Rey, CA 90292
Phone (310) 823-4595

13161 Mindanao Way
#D-6
Marina del Rey, CA 90292
Phone (310) 823-4595

1026 W West Covina Pkwy
Ste B
West Covina, CA 91790
Phone (626) 593-4234

11245 Washington Blvd
Whittier, CA 90606
Phone (562) 692-1208

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kristine.kobayashi@uprisedirect.com

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": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476144000000",
    "number": "1922095439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4266 LINCOLN BLVD",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925618",
            "telephone_number": "310-823-4595",
            "fax_number": "310-823-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11245 WASHINGTON BLVD",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906063111",
            "telephone_number": "562-692-1208",
            "fax_number": "626-856-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBAYASHI",
        "first_name": "KRISTINE",
        "middle_name": "MICHI",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-29",
        "last_updated": "2016-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0094440",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

Verify at the official NPI Registry.