Individual provider Active NPI

Marc C Kaneshiro, M.D.

  • Gastroenterology Physician
  • West Hollywood, CA
National Provider Identifier
1083865836
Registry record updated Aug 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
109630 Issued in CA
Practice address
8700 Beverly Blvd
West Hollywood, CA 90048-1804
Phone
(310) 423-4611
NPI assigned
Oct 9, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A109630 CA
Gastroenterology Physician 207RG0100X 109630 CA Primary

Addresses

Primary practice location

8700 Beverly Blvd
West Hollywood, CA 90048-1804

Mailing address

8700 Beverly Bldvd
Los Angeles, CA 90048

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
I20110629000127 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 0042498768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of Hawaii John a. Burns School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Regents of the University of CaliforniaGroup PAC ID 1355248584, 1,426 clinicians

Practice addresses (Care Compare)

200 UCLA Medical PLZ
Suite 365
Los Angeles, CA 90095-8344
Phone (310) 206-1467

Hospital & facility affiliations

  • Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262
  • Santa Monica - UCLA Med Ctr & Orthopaedic Hospital Hospital, Santa Monica, CA, CCN 050112

Merit-based Incentive Payment System (MIPS)

Final score
87.51 of 100Reported as group
Quality
79.37
Promoting interoperability
100
Improvement activities
40
Cost
73.65

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy84
Upper gastrointestinal (GI) endoscopy for acid reflux130

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
109630CAMDGeneral Practice Dentistry
A109630CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California CurrentSince Aug 1, 2015 Accepting new patients
The Regents of the University of California Internal Medicine CurrentSince Aug 1, 2015 Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
UCLA Medical Group Internal Medicine Past Accepting new patients

Locations

24302 Paseo de Valencia
Ste 200
Laguna Hills, CA 92653
Phone (949) 458-8252

5767 W Century Blvd
#400
Los Angeles, CA 90045

100 UCLA Medical Plz
Ste 205
Los Angeles, CA 90024
Phone (310) 208-5400

200 UCLA Medical Plz
Ste 365
Los Angeles, CA 90095
Phone (310) 206-1467

55737 File
Los Angeles, CA 90074

File 55737
Los Angeles, CA 90074

892 Aerovista Pl
Ste 240
San Luis Obispo, CA 93401
Phone (805) 541-8252

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

100 Moody Ct
Ste 200
Thousand Oaks, CA 91360
Phone (805) 418-3500

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.

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": "1223510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439251200000",
    "number": "1083865836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8700 BEVERLY BLDVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 BEVERLY BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900481804",
            "telephone_number": "310-423-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANESHIRO",
        "first_name": "MARC",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-09",
        "last_updated": "2015-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A109630",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "109630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hollywood, CA

Sources for this page

Verify at the official NPI Registry.