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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KIDISTI GHEBRE MARIAM OD
NPI 1477508331
Optometrist in Antioch, CA

Active since May 22, 2006
2201 VERNE ROBERTS CIR, ANTIOCH, CA 94509(925) 757-1183 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kidisti Ghebre Mariam Od NPPES

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

KIDISTI GHEBRE MARIAM OD (NPI 1477508331) is an individual optometrist in Antioch, California, licensed in California (11703T) and active in the NPI registry since May 2006.

NPPES Registry Identity

NPI1477508331
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameKIDISTI GHEBRE MARIAMCredential: OD
Location Address2201 VERNE ROBERTS CIRAntioch, CA 94509-7911
Mailing Address533 Ridgeview CtPleasant Hill, CA 94523-1023 · (925) 228-2585
Phone(925) 757-1183
Sole ProprietorNo
Enumeration DateMay 22, 2006
Last NPPES UpdateJuly 13, 2026
✔ NPI 1477508331 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 · 11703T
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.
2201 VERNE ROBERTS CIR, Antioch, CA 94509
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, Blue Cross Blue Shield of Wyoming.Insurance ›

Other Providers at the Same Location NPPES 5

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

COSTCO WHOLESALE CORPORATION
Pharmacy (Community/Retail Pharmacy)
2201 VERNE ROBERTS CIR
ANTIOCH, CA 94509
Contra Costa County (925) 470-4612
ANTIOCH OPTOMETRY, PC
Optometrist
2201 VERNE ROBERTS CIR
ANTIOCH, CA 94509
Contra Costa County (925) 470-4616
CONSTANCE NG PHARM.D
Pharmacist
2201 VERNE ROBERTS CIR
ANTIOCH, CA 94509
Contra Costa County (925) 757-1933
COSTCO WHOLESALE CORPORATION
Eyewear Supplier
2201 VERNE ROBERTS CIR
ANTIOCH, CA 94509
Contra Costa County (925) 757-6091
COSTCO WHOLESALE CORPORATION
Hearing Aid Equipment
2201 VERNE ROBERTS CIR
ANTIOCH, CA 94509
Contra Costa County (925) 470-4603

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 Kidisti Mariam's NPI number?

The NPI number for Kidisti Mariam is 1477508331. It was assigned to this individual provider in the NPPES registry on May 22, 2006.

Where is Kidisti Mariam located?

Kidisti Mariam practices at 2201 Verne Roberts Cir, Antioch, CA 94509. The listed phone number is (925) 757-1183.

What is Kidisti Mariam's specialty?

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

What insurance does Kidisti Mariam accept?

Health plans from Blue Cross Blue Shield of Wyoming and Blue Cross and Blue Shield of Louisiana list Kidisti Mariam as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kidisti Mariam was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 31 days 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.