Tetsuo Ishimori, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

A30114 Issued in CA

Practice address

2901 Sillect Ave
Suite 100
Bakersfield, CA 93308-6370

Phone

(661) 323-8384

Fax

(661) 323-9326

NPI assigned

Jun 8, 2007

Last updated

May 6, 2009By the provider in NPPES

Sex

Male

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

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/kernvh-26e64ef3

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.

• Kern Valley Healthcare District

  • Critical Access Hospital
  • Lake Isabella, CA
  • NPI 1427049964
  NPD
• Kern Valley Healthcare District

  dba Mountain View Health Clinic

  • Rural Health Clinic/Center
  • Mt Mesa, CA
  • NPI 1457854192
  NPD

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241568000000",
    "number": "1073716874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1139",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933021139",
            "telephone_number": "661-323-8384",
            "fax_number": "661-323-9326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 SILLECT AVE",
            "address_2": "SUITE 100",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933086370",
            "telephone_number": "661-323-8384",
            "fax_number": "661-323-9326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISHIMORI",
        "first_name": "TETSUO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-08",
        "last_updated": "2009-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A30114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PTAN",
            "identifier": "00A301141",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060012146",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "953511288",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Isaac Kim Crna Inc., a Professional Nursing Corporation
• Courtney Samon Isaac, LMFT
• Kristine Kay Isenman, PA-C
• Ish Gulati MD Inc
• Ishaan S. Kalha, MD Inc.
• Maricel A. Isidro-Reighard, CRNA
• Khandhaker Shababa Islam
• Ismailyan Professional Dental Corporation
• Ani Hakobyan Ismailyan, D.M.D.
• Arbi Ismailyan, DMD

• Cardiovascular Disease Physician in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.