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KEIKO KITAMURA O.D.
NPI 1104924356
Optometrist in Los Angeles, CA

Active since September 20, 2006PECOS EnrolledAccepts Medicare Assignment
420 E 3RD ST STE 603, LOS ANGELES, CA 90013(213) 680-1551(213) 680-2148 Get Directions Write a Review

NPPES record last updated: December 6, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Keiko Kitamura O.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEIKO KITAMURA O.D. (NPI 1104924356) is an individual optometrist in Los Angeles, California, licensed in California (OPT 13035 TPA) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS and is a graduate of Southern California College Of Optometry (2006).

NPPES Registry Identity

NPI1104924356
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameKEIKO KITAMURACredential: O.D.
Location Address420 E 3RD ST STE 603Los Angeles, CA 90013-1645
Mailing Address2239 Jeslew CtHacienda Heights, CA 91745-6843 · (626) 833-7680
Phone(213) 680-1551
Fax(213) 680-2148
Sole ProprietorNo
Medical School CMSSouthern California College Of OptometryGraduated 2006
Enumeration DateSeptember 20, 2006
Last NPPES UpdateDecember 6, 2021
✔ NPI 1104924356 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in CA · OPT 13035 TPA
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
420 E 3RD ST STE 603, Los Angeles, CA 90013
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Keiko Kitamura O.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6507968534
PECOS Enrollment IDI20070222000297
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Keiko Kitamura reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group
28 mi
Clinical Medical Laboratory
13000 PEYTON DR
Chino Hills, CA 91709
  • Reassigned Medicare billing, California enrollment
  • 5,228 clinicians in this Medicare group
NPI 1396287082 (888) 750-0036

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90013 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$142.39 typical visit price
range $62.96 – $187.60
Typical copayment $35.59 (range $15.74 – $46.90)
Most-billed visit code 99204
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HAROLD E REAVES M.D.,INC
Specialist
420 E 3RD ST STE 603
LOS ANGELES, CA 90013
Los Angeles County (213) 680-1551
DALIA SAADAT O.D.
Optometrist
420 E 3RD ST STE 603
LOS ANGELES, CA 90013
Los Angeles County (213) 680-1551
DR. ERIC SOOYONG AHN MD
Ophthalmology (Ophthalmic Plastic and Reconstructive Surgery)
420 E 3RD ST STE 603
LOS ANGELES, CA 90013
Los Angeles County (213) 680-1551

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Keiko Kitamura's NPI number?

The NPI number for Keiko Kitamura is 1104924356. It was assigned to this individual provider in the NPPES registry on September 20, 2006.

Where is Keiko Kitamura located?

Keiko Kitamura practices at 420 E 3rd St Ste 603, Los Angeles, CA 90013. The listed phone number is (213) 680-1551.

What is Keiko Kitamura's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Keiko Kitamura enrolled in Medicare?

Yes. Keiko Kitamura is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Keiko Kitamura's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Keiko Kitamura reassigns Medicare benefits to Southern California Permanente Medical Group (Chino Hills, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Keiko Kitamura's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Keiko Kitamura was last updated on December 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.