Individual provider Active NPI

Hisako Ohmoto Leung

  • Rheumatology Physician
  • Pleasanton, CA
National Provider Identifier
1194826354
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
A73077 Issued in CA
Practice address
4466 Black Ave
Suite a
Pleasanton, CA 94566-6143
Phone
(925) 600-8220
Fax
(925) 600-8221
NPI assigned
Sep 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X A73077 CA Primary

Addresses

Primary practice location

4466 Black Ave
Suite a
Pleasanton, CA 94566-6143

Mailing address

4466 Black Ave
Suite a
Pleasanton, CA 94566-6143
Phone (925) 600-8220

Other names 1

  • Hisako Ohmoto Professional name

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
I20040910001146 CA Practitioner - RheumatologyPractitioner - Internal Medicine 7719954635 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Creighton University School of Medicine, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4466 Black Ave
Suite a
Pleasanton, CA 94566-6130
Phone (925) 600-8220

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A73077CAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hisako Ohmoto MD Inc Rheumatology CurrentSince Oct 5, 2004 Accepting new patients

Locations

4466 Black Ave
Ste A
Pleasanton, CA 94566
Phone (925) 600-8220

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194826354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4466 BLACK AVE",
            "address_2": "SUITE A",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945666143",
            "telephone_number": "925-600-8220",
            "fax_number": "925-600-8221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4466 BLACK AVE",
            "address_2": "SUITE A",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945666143",
            "telephone_number": "925-600-8220",
            "fax_number": "925-600-8221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEUNG",
        "first_name": "HISAKO",
        "middle_name": "OHMOTO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": "A73077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HISAKO",
            "last_name": "OHMOTO",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.