Individual provider Active NPI

Michio Kajitani, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • San Bernardino, CA
National Provider Identifier
1194704387
Registry record updated Feb 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
A89049 Issued in CA
Practice address
401 E Highland Ave Ste 251
San Bernardino, CA 92404-3800
Phone
(909) 882-4605
Fax
(909) 475-2680
NPI assigned
Jan 16, 2006
Last updated
Feb 14, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X E-2437 AR
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X A89049 CA Primary

Addresses

Primary practice location

401 E Highland Ave Ste 251
San Bernardino, CA 92404-3800

Mailing address

3400 Data Dr
Attn: Credentialing/Payer Enrollment
Rancho Cordova, CA 95670-7956

Other identifiers 1

IdentifierTypeStateIssuer
148852001MedicaidAR

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
I20091111000538 CA Practitioner - Thoracic SurgeryPractitioner - Vascular Surgery 1456250778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic SurgeryAlso: Vascular Surgery
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

401 E Highland Ave
Suite 251
San Bernardino, CA 92404-3800
Phone (909) 882-4605

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
89049CAMDClinical Social Worker
A89049CAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation CurrentSince Dec 5, 2016 Accepting new patients
Dignity Health Medical Foundation Current Accepting new patients
Dignity Health Medical Foundation CurrentSince Dec 5, 2016 Accepting new patients
Dignity Health Medical Foundation Past Accepting new patients
Little Rock Cardiology Clinic, PA Past Accepting new patients
Baptist Health Past Accepting new patients
Arkansas Cardiovascular Surgery Associates,P.a. Past Accepting new patients
Cardiac and Vascular Surgeons PA Past Accepting new patients
Baptist Health Past Accepting new patients
Baptist Health Past Accepting new patients
Dignity Health Past Accepting new patients
S. Thomas Rayburn III, MD, P.a. Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
St Vincent Infirmary Medical Center Past Accepting new patients
Arkansas Heart Hospital, LLC Past Accepting new patients
Heart Surgery Little Rock, P.a. Thoracic Surgery (Cardiothoracic Vascular Surgery) PastSince Nov 1, 2003 Accepting new patients

Locations

280 Sierra College Dr
Ste 120
Grass Valley, CA 95945
Phone (530) 477-4420

3400 Data Dr
Fl 1
Rancho Cordova, CA 95670
Phone (916) 379-2726

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

401 E Highland Ave
Ste 450A
San Bernardino, CA 92404
Phone (909) 864-4700

401 E Highland Ave
Ste 251
Sn Bernrdno, CA 92404
Phone (909) 881-1614

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 1

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": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518566400000",
    "number": "1194704387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "address_2": "ATTN: CREDENTIALING/PAYER ENROLLMENT",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E HIGHLAND AVE STE 251",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924043800",
            "telephone_number": "909-882-4605",
            "fax_number": "909-475-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAJITANI",
        "first_name": "MICHIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-16",
        "last_updated": "2018-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "AR",
            "license": "E-2437",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "A89049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148852001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.