ELK GROVE OPTOMETRY A PROFESSIONAL CORPORATION
NPI 1306895545
Optometrist in Elk Grove, CA
NPI Status: Active since May 06, 2006
Contact Information
9401 E STOCKTON BLVD
STE 105
ELK GROVE, CA
ZIP 95624
Phone: (916) 686-4937
Fax: (916) 686-4469
- Organization
- Optometrist
- Accepts Insurance
- Medicare Supplier
- Does Not Accept Medicare Approved Payment
- CLIA Number: 05D2077746
- CLIA Cert. Type: Practitioner Other
- CLIA Exp. Date: 05-13-2026
About ELK GROVE OPTOMETRY A PROFESSIONAL CORPORATION
This page provides the complete NPI Profile along with additional information for Elk Grove Optometry A Professional Corporation, a provider established in Elk Grove, California operating as a Optometrist. The healthcare provider is registered in the NPI registry with number 1306895545 assigned on May 2006. The practitioner's primary taxonomy code is 152W00000X. The provider is registered as an organization and their NPI record was last updated 13 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. David T Kageyama Od (President)
- NPI
- 1306895545
- Provider Name
- ELK GROVE OPTOMETRY A PROFESSIONAL CORPORATION
- Entity Type
- Organization
- Location Address
- 9401 E STOCKTON BLVD STE 105 ELK GROVE, CA 95624
- Location Phone
- (916) 686-4937
- Location Fax
- (916) 686-4469
- Mailing Address
- 9401 E STOCKTON BLVD STE 105 ELK GROVE, CA 95624
- Mailing Phone
- (916) 686-4937
- Mailing Fax
- (916) 686-4469
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-06-2006
- Last Update Date
- 10-29-2013
- Code Navigator
Elk Grove Optometry A Professional Corporation is a medicare supplier with PTAN 20517635 who does not accept Medicare assignment for all durable medical equipment and supplies. The provider may not accept the Medicare allowable as payment in full and may collect additional payment directly from the patient, and/or charge more than the Medicare allowable.The supplier carries the following product categories: Prosthetic Lenses: Conventional Eyeglasses or Prosthetic Lenses: Conventional Contact Lenses or Prosthetic Lenses: Prosthetics Cataract Lenses.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Optometrist
- Taxonomy Code
- 152W00000X
- Type
- Eye and Vision Services Providers
- Taxonomy Description
- 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.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health� - EPO
- BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health� - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 0433340001 | MEDICARE NSC (07) | CA | |
| GZ602A | MEDICARE PIN (08) | CA | |
| GDS00190 | MEDICAID (05) | CA |
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20517635
- Accepts Medicare Assignment
- NO
- Specialities List
- Optometrist.
- Competitive Bidding
- NO
Supplies List
- Prosthetic Lenses: Conventional Eyeglasses - Conventional Eyeglasses
- Prosthetic Lenses: Conventional Contact Lenses - Conventional Contact Lenses
- Prosthetic Lenses: Prosthetics Cataract Lenses - Cataract Eyeglasses
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D2077746
- Facility Type
- Practitioner Other
- Certificate Effective Date
- May 14, 2024
- Certificate Expiration Date
- May 13, 2026
- Laboratory Director
- DAVID T. KAGEYAMA, OD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Elk Grove Optometry A Professional Corporation to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1306895545, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 65 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 5 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1306895545, enumerated as an "organization" on May 06, 2006.
The provider is located at 9401 E STOCKTON BLVD STE 105 ELK GROVE, CA 95624 and the phone number is (916) 686-4937.
Optometrist with taxonomy code 152W00000X.
The provider might be accepting Accepts: BlueCross BlueShield of Tennessee, Medicare and. Please consult your insurance carrier or call the provider to verify.
