Individual provider Active NPI

Kevin Akira Fukuda, MD

  • Anesthesiology Physician
  • Burlingame, CA
National Provider Identifier
1063449759
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G81100 Issued in CA
Practice address
1783 El Camino Real
Burlingame, CA 94010-3205
Phone
(650) 696-5400
Fax
(650) 696-5208
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G81100 CA Primary

Addresses

Primary practice location

1783 El Camino Real
Burlingame, CA 94010-3205

Mailing address

PO Box 7793
San Francisco, CA 94120-7793

Other identifiers 1

IdentifierTypeStateIssuer
00G811000MedicaidCA

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
I20081029000755 CA Practitioner - Anesthesiology 5799844189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Georgetown University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Care Associates Medical Group, IncGroup PAC ID 1850334384, 108 clinicians

Practice addresses (Care Compare)

1501 Trousdale Dr
Burlingame, CA 94010-4506
Phone (650) 696-5400

Hospital & facility affiliations

  • Peninsula Medical Center Hospital, Burlingame, CA, CCN 050007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G81100CAMDAnesthesiology Physician
81100CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Care Associates Medical Group Inc Anesthesiology CurrentSince Mar 1, 2001 Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Mills-Peninsula Health Services Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients
Northern California Anesthesia Anesthesiology Past Accepting new patients

Locations

1783 El Camino Real
Burlingame, CA 94010
Phone (650) 696-5400

1501 Trousdale Dr
Burlingame, CA 94010
Phone (650) 696-3520

180 Rowland Way
Novato, CA 94945
Phone (415) 209-1300

100 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 696-4140

Interoperability endpoints

  • Direct secure messaging: kfukuda45712@hisp.ehr.sutterhealth.org

Organizations & group practices 6

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 2

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063449759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7793",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941207793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1783 EL CAMINO REAL",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103205",
            "telephone_number": "650-696-5400",
            "fax_number": "650-696-5208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUKUDA",
        "first_name": "KEVIN",
        "middle_name": "AKIRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G81100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G811000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlingame, CA

Sources for this page

Verify at the official NPI Registry.