Individual provider Active NPI

Evelyn Junko Nakagawa, M.D.

  • Internal Medicine Physician
  • San Leandro, CA
National Provider Identifier
1023077294
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A68752 Issued in CA
Practice address
2800 Benedict Dr
San Leandro, CA 94577-6840
Phone
(415) 233-3604
Fax
(415) 295-5109
NPI assigned
Mar 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A68752 CA Primary

Addresses

Primary practice location

2800 Benedict Dr
San Leandro, CA 94577-6840

Mailing address

14 Tamal Vista Blvd
Corte Madera, CA 94925-1107
Phone (415) 233-3604

Other identifiers 1

IdentifierTypeStateIssuer
00A687250MedicaidCA

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
I20090114000604 CA Practitioner - Internal MedicinePractitioner - Hospitalist 7214090414 Reassigns benefits to 4 organizations
Receives reassigned benefits from 1 practitioner
Practice locations: Greenbrae, CA; Mill Valley, CA; Petaluma, CA; San Leandro, CA; San Rafael, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Medical College of Pennsylvania, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evelyn J Nakagawa MD IncGroup PAC ID 2466846399, 3 clinicians

Practice addresses (Care Compare)

2800 Benedict Dr
San Leandro, CA 94577-6840
Phone (415) 945-1010

Hospital & facility affiliations

  • Alta Bates Summit Medical Center - Alta Bates Camp Hospital, Berkeley, CA, CCN 050305
  • Alta Bates Summit Medical Center Hospital, Oakland, CA, CCN 050043
  • Kindred Hospital - San Francisco Bay Area Long-term care hospital, San Leandro, CA, CCN 052034
  • Smith Ranch Skilled Nursing & Rehabilitation Cente Nursing home, San Rafael, CA, CCN 555595
  • South Marin Health & Wellness Center Nursing home, Greenbrae, CA, CCN 055093
  • North Bay Post Acute Nursing home, Petaluma, CA, CCN 056120
  • The Redwoods, a Community of Seniors Nursing home, Mill Valley, CA, CCN 555826

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A68752CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Evelyn J Nakagawa MD Inc Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
KND Development 59 LLC Current Accepting new patients
Inpatient Consultants of California, Inc. Internal Medicine CurrentSince Nov 13, 2002 Accepting new patients
Quantum Healthcare Medical Associates Inc. Internal Medicine CurrentSince May 1, 2017 Accepting new patients
KND Development 59, LLC CurrentSince Jun 20, 2023 Accepting new patients
KND Development 59, LLC CurrentSince Jun 20, 2023 Accepting new patients
The Redwoods, a Community of Seniors Past Accepting new patients

Locations

1652 Mono Ave
Ashland, CA 94578
Phone (510) 357-5351

1510 4th St
Ste 1
Berkeley, CA 94710
Phone (510) 525-8980

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800

1220 S Eliseo Dr
Greenbrae, CA 94904
Phone (415) 461-0748

1141 Catalina Dr
#194
Livermore, CA 94550

40 Camino Alto
Ofc
Mill Valley, CA 94941
Phone (415) 383-2741

550 N Monterey Ave
Ontario, CA 91764
Phone (909) 629-2290

400 N McDowell Blvd
Petaluma, CA 94954
Phone (707) 778-1111

300 Douglas St
Petaluma, CA 94952
Phone (415) 945-1010

2800 Benedict Dr
San Leandro, CA 94577
Phone (510) 357-8300

2000 Vale Rd
San Pablo, CA 94806
Phone (510) 235-7000

1550 Silveira Pkwy
San Rafael, CA 94903
Phone (415) 446-3817

234 N San Pedro Rd
San Rafael, CA 94903
Phone (415) 479-3450

300 Hospital Dr
Vallejo, CA 94589
Phone (707) 554-4107

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Organizations & group practices 7

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1023077294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 TAMAL VISTA BLVD",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251107",
            "telephone_number": "415-233-3604",
            "fax_number": "415-295-5109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 BENEDICT DR",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945776840",
            "telephone_number": "415-233-3604",
            "fax_number": "415-295-5109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKAGAWA",
        "first_name": "EVELYN",
        "middle_name": "JUNKO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A68752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A687250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

Verify at the official NPI Registry.