NPIMap

Individual provider Active NPI

Charlie Loc Kano, MD

  • Family Medicine Physician
  • Merced, CA
National Provider Identifier
1003927567
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G74907 Issued in CA
Practice address
127 W El Portal Dr
Merced, CA 95348-2853
Phone
(209) 723-3704
Fax
(209) 723-0272
NPI assigned
Aug 31, 2006
Last updated
Dec 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G74907 CA Primary

Addresses

Primary practice location

127 W El Portal Dr
Merced, CA 95348-2853

Mailing address

PO Box 3768
Merced, CA 95344-3768
Phone (209) 723-3704

Other identifiers 1

IdentifierTypeStateIssuer
00G749070MedicaidCA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address charlie.kano.1@3012.direct.athenahealth.com Direct
Direct Messaging Address charlie.kano.1@3012.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040913000502 CA Practitioner - Family Practice 7719954759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Wisconsin School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

127 W El Portal Dr
Merced, CA 95348-2853
Phone (209) 723-3704

1675 Shaffer Rd
Atwater, CA 95301-4456
Phone (209) 383-5500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G74907CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Merced Faculty Associates Medical Group Incorporated Family Medicine CurrentSince Sep 1, 1998 Accepting new patients
Merced Faculty Associates Medical Group Incorporated Family Medicine Current Accepting new patients
Dignity Health Past Accepting new patients
Merced Faculty Associates Medical Group Incorporated Family Medicine Past Accepting new patients
Merced Faculty Associates Medical Group Incorporated Family Medicine Past Accepting new patients

Locations

1675 Shaffer Rd
Atwater, CA 95301
Phone (209) 357-5121

127 W El Portal Dr
Merced, CA 95348
Phone (209) 723-3704

220 E 13th St
Merced, CA 95341
Phone (209) 723-2122

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: charlie.kano.1@3012.direct.athenahealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1003927567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3768",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953443768",
            "telephone_number": "209-723-3704",
            "fax_number": "209-726-0272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 W EL PORTAL DR",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953482853",
            "telephone_number": "209-723-3704",
            "fax_number": "209-723-0272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANO",
        "first_name": "CHARLIE",
        "middle_name": "LOC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G74907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G749070",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charlie.kano.1@3012.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "127 W El Portal Dr",
            "city": "Merced",
            "state": "CA",
            "country_code": "US",
            "postal_code": "953482853",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charlie.kano.1@3012.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1675 Shaffer Rd",
            "city": "Atwater",
            "state": "CA",
            "country_code": "US",
            "postal_code": "953014456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

Verify at the official NPI Registry.