Mitchell Nishimoto, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G76976 Issued in CA

Practice address

15243 Vanowen St
Suite 406
Van Nuys, CA 91405-3605

Phone

(818) 785-3889

Fax

(818) 780-2106

NPI assigned

Sep 26, 2006

Sex

Male

Sole proprietor

No

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

University of California, Davis School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Mitchell M Nishimoto Medical Corporation

  • Medical Specialty Clinic/Center
  • Van Nuys, CA
  • NPI 1518435551
  Medicare reassignment NPD Authorized official
• Brotman Medical Center, Inc.

  • Skilled Nursing Facility
  • Culver City, CA
  • NPI 1518997733
  NPD (past)
• Providence Saint John'S Health Center

  • General Acute Care Hospital
  • Santa Monica, CA
  • NPI 1124026273
  NPD (past)
• Southern California Healthcare System, Inc

  • Psychiatric Hospital Unit
  • Culver City, CA
  • NPI 1487905725
  NPD (past)
• Valley Presbyterian Hospital

  • General Acute Care Hospital
  • Van Nuys, CA
  • NPI 1578529285
  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537833600000",
    "number": "1003917287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15243 VANOWEN ST",
            "address_2": "STE 408",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053658",
            "telephone_number": "818-785-3889",
            "fax_number": "818-780-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15243 VANOWEN ST",
            "address_2": "SUITE 406",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053605",
            "telephone_number": "818-785-3889",
            "fax_number": "818-780-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISHIMOTO",
        "first_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2018-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G76976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Samantha Nino
• Nirvana Gardens Assisted Living LLC
• Nirvana Home Health Care, Inc
• Nirvana Home Health, Inc.
• Nirvana Hospice Inc.
• Nisman & Bacquet, D.D.S., Inc.
• Noah Home Health Care, Inc.
• Carlos Fernando Noble, CATC
• Rebecca Noble
• Noblequest Health Foundation, Inc.

• Internal Medicine Physician in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; 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.