Carol Yukiko Nishikubo, M.D.

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

G78746 Issued in CA

Practice address

2001 Santa Monica Blvd Ste 560W
Santa Monica, CA 90404-2182

Phone

(310) 453-5654

Fax

(310) 453-6885

NPI assigned

Feb 22, 2006

Last updated

Jan 23, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 2

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

Hematology/Oncology

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Saint Johns Medical FoundationGroup PAC ID 0840548624, 282 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint John's Health Center Hospital, Santa Monica, CA, CCN 050290

Merit-based Incentive Payment System (MIPS)

Final score

90.42 of 100Reported as group

Quality

96.07

Promoting interoperability

100

Improvement activities

40

Cost

71.98

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Providence Saint Johns Medical Foundation

  dba Saint John's Physician Partners

  • Specialist
  • Santa Monica, CA
  • NPI 1770093734
  Medicare reassignment Care Compare group NPD

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

• Providence Saint John's Health Center

  • General Acute Care Hospital
  • Santa Monica, CA
  • NPI 1124026273
  Care Compare affiliation

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1023083888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 SANTA MONICA BLVD",
            "address_2": "SUITE 400E",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042208",
            "telephone_number": "310-453-5654",
            "fax_number": "310-453-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD STE 560W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042182",
            "telephone_number": "310-453-5654",
            "fax_number": "310-453-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISHIKUBO",
        "first_name": "CAROL",
        "middle_name": "YUKIKO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-22",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "G78746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA LICENSE",
            "identifier": "G78746",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G787460",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0085740",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cnishikubo473085@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2021 Santa Monica Blvd Ste 400E",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904042103",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cnishikubo473085@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "12555 W Jefferson Blvd Ste 303",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900667032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mordechai Saied Nikfar, RPH
• Vahid Niki, DDS
• Nahal Niknam, D.D.S
• Niloufar Ehya Inc
• Midori Nishida, N.D.
• Angela Yat-Sun Nishio, M.D.
• Matthew David Nitti, MD
• Rhiane Niumata, PMHNP
• Elaime Odell Nixon
• Solange Nkafu, LVN

• Hematology & Oncology Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Hematology & Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.