Individual provider Active NPI

Tina Shizuko Kami

  • Family Nurse Practitioner
  • Anaheim, CA
National Provider Identifier
1063990133
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NPF95009496 Issued in CA
Practice address
3356 W Ball Rd Ste 100
Anaheim, CA 92804-3727
Phone
(714) 827-6625
Fax
(714) 827-9726
NPI assigned
Aug 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NPF95009496 CA Primary

Addresses

Primary practice location

3356 W Ball Rd Ste 100
Anaheim, CA 92804-3727

Mailing address

2509 S Deegan Dr
Santa Ana, CA 92704-5504
Phone (714) 612-3158

Other practice location 1

2509 S Deegan Dr
Santa Ana, CA 92704-5504
Phone (714) 612-3158

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tskami@hotail.com Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NPF95009496CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Management Center of Irvine, Inc. Current Accepting new patients
Global Transitional Care, LLC CurrentSince Jul 25, 2022 Accepting new patients
Signify Health Medical Associates of California, PC CurrentSince Apr 1, 2023 Accepting new patients
Omar O. Fadeel, MD PastSince Oct 20, 2019 Accepting new patients

Locations

5161 California Ave
Ste 200
Irvine, CA 92617
Phone (949) 543-0124

818 W 7th St
Ste 930
Los Angeles, CA 90017
Phone (800) 525-9202

505 Montgomery St
Fl 10
San Francisco, CA 94111
Phone (503) 427-8095

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 4

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": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1063990133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2509 S DEEGAN DR",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927045504",
            "telephone_number": "714-612-3158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3356 W BALL RD STE 100",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043727",
            "telephone_number": "714-827-6625",
            "fax_number": "714-827-9726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2509 S Deegan Dr",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927045504",
            "country_code": "US",
            "telephone_number": "714-612-3158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMI",
        "first_name": "TINA",
        "middle_name": "SHIZUKO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-01",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NPF95009496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tskami@hotail.com",
            "affiliation": "N",
            "endpointDescription": "NA",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "NA",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "NA",
            "address_1": "3356 W Ball Rd Ste 100",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928043727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.