Active NPI
Kyle Scott Nakamoto, PA-C
- Physician Assistant
- Orange, CA
National Provider Identifier
1154831915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 56965
- Practice address
- 101 The City Dr S
Orange, CA 92868-3201 - Phone
- (714) 456-8888
- NPI assigned
- Oct 6, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA-1564 | ID | |
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | 56965 | CA | Primary |
Addresses
Primary practice location
101 The City Dr S
Orange, CA 92868-3201
Mailing address
6801 Park Ter Ste 500
Los Angeles, CA 90045-9212
Phone (310) 665-7200
Other practice location 1
6801 Park Ter Ste 500
Los Angeles, CA 90045-9212
Phone (310) 665-7200
Other practice location 2
2400 E Katella Ave Ste 400
Anaheim, CA 92806-5972
Phone (310) 665-7200
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-7004
Hospital & facility affiliations
- Uci Health-Orange
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56965 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of California Irvine | Past | Accepting new patients | |
| Regents of the University of Claifornia Univ Neursciences | Past | Accepting new patients |
Organizations & group practices 5
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.
-
- Neurological Surgery Physician
- Orange, CA
- NPI 1659329746
-
- Specialist
- Los Angeles, CA
- NPI 1316984388
-
- Emergency Medicine Physician
- Orange, CA
- NPI 1740214733
-
- Neurology Physician
- Orange, CA
- NPI 1205884210
-
- Infusion Therapy Clinic/Center
- Irvine, CA
- NPI 1417027475
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Orange, CA
- NPI 1689608150
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726790400000",
"number": "1154831915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6801 PARK TER STE 500",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900459212",
"telephone_number": "310-665-7200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 THE CITY DR S",
"city": "ORANGE",
"state": "CA",
"postal_code": "928683201",
"telephone_number": "714-456-8888"
}
],
"practiceLocations": [
{
"address_1": "6801 Park Ter Ste 500",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900459212",
"country_code": "US",
"telephone_number": "310-665-7200",
"fax_number": "714-937-1814",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2400 E Katella Ave Ste 400",
"address_purpose": "LOCATION",
"city": "Anaheim",
"state": "CA",
"postal_code": "928065972",
"country_code": "US",
"telephone_number": "310-665-7200",
"fax_number": "714-937-1814",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NAKAMOTO",
"first_name": "KYLE",
"middle_name": "SCOTT",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-10-06",
"last_updated": "2024-09-20",
"certification_date": "2024-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ID",
"license": "PA-1564",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "56965",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.