Individual provider Active NPI

Elvis-Raymond Mukwikwi

  • Geriatric Psychiatry Physician
  • Palo Alto, CA
National Provider Identifier
1013705334
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
201564 Issued in CA
Practice address
401 Quarry Rd
Palo Alto, CA 94304-1419
Phone
(650) 723-6643
NPI assigned
Apr 28, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Psychiatry Physician 2084P0805X 201564 CA Primary

Addresses

Primary practice location

401 Quarry Rd
Palo Alto, CA 94304-1419

Mailing address

401 Quarry Rd
Palo Alto, CA 94304-1419

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251222002327 CA Practitioner - Geriatric Psychiatry 3678068137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric Psychiatry
Education
Universite de Montreal, Faculte de Medecine, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Altos Health PartnersGroup PAC ID 2567779606, 4 clinicians

Practice addresses (Care Compare)

2500 Grant Rd
Mountain View, CA 94040-4302
Phone (650) 988-7626

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201564CAMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Altos Health Partners CurrentSince Nov 1, 2025 Accepting new patients

Locations

2500 Grant Rd
Mountain View, CA 94040
Phone (650) 903-9500

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1745798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1013705334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 QUARRY RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 QUARRY RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041419",
            "telephone_number": "650-723-6643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKWIKWI",
        "first_name": "ELVIS-RAYMOND",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-28",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "CA",
            "license": "201564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.