Individual provider Active NPI

Nathan Aron Kiskila, M.D.

  • Family Medicine Physician
  • Newport Beach, CA
National Provider Identifier
1235265844
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A104532 Issued in CA
Practice address
2075 San Joaquin Hills Rd
Newport Beach, CA 92660-6505
Phone
(949) 760-9222
Fax
(949) 644-4312
NPI assigned
Feb 26, 2007
Last updated
Jun 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A104532 CA Primary

Addresses

Primary practice location

2075 San Joaquin Hills Rd
Newport Beach, CA 92660-6505

Mailing address

2075 San Joaquin Hills Rd
Newport Beach, CA 92660-6505
Phone (949) 760-9222

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
I20110616000738 CA Practitioner - Family Practice 3870660103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York Medical College, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Marque Medical Clinic, Inc.Group PAC ID 9537345665, 21 clinicians

Practice addresses (Care Compare)

2075 San Joaquin Hills Rd
Newport Beach, CA 92660-6505
Phone (877) 693-6266

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A104532CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marque Medical Clinic, Inc CurrentSince Apr 2, 2011 Accepting new patients
Marque Medical Clinic, Inc. Family Medicine CurrentSince Jul 21, 2016 Accepting new patients
Marque Medical Clinic, Inc Past Accepting new patients
Marque Medical Clinic, Inc Past Accepting new patients
Marque Medical Clinic, Inc Past Accepting new patients
Marque Medical Clinic, Inc. Past Accepting new patients
Marque Medical Clinic, Inc. Past Accepting new patients
Marque Medical Clinic, Inc Past Accepting new patients
Marque Medical Clinic, Inc. Past Accepting new patients
Marque Medical Clinic, Inc. Past Accepting new patients
Marque Medical Clinic, Inc Past Accepting new patients
Marque Medical Clinic, Inc. Past Accepting new patients
Marque Medical Clinic, Inc. Past Accepting new patients
Marque Medical Clinic, Inc. Past Accepting new patients
Marque Medical Clinic, Inc. Past Accepting new patients

Locations

2315 Otay Lakes Rd
Ste 306
Chula Vista, CA 91915
Phone (619) 946-4700

605 E Palomar St
Ste 103
Chula Vista, CA 91911
Phone (877) 693-6266

9630 Sierra Ave
#100
Fontana, CA 92335
Phone (877) 693-6266

21770 LK FRST Dr
Ste 109
Lake Forest, CA 92630
Phone (877) 693-6266

2075 San Joaquin Hills Rd
Newport Beach, CA 92660
Phone (877) 693-6266

10391 Magnolia Ave
Riverside, CA 92505

4490 Fanuel St
Ste 100
San Diego, CA 92109

4155 Tweedy Blvd
South Gate, CA 90280
Phone (323) 569-0744

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

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1235265844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2075 SAN JOAQUIN HILLS RD",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926606505",
            "telephone_number": "949-760-9222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 SAN JOAQUIN HILLS RD",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926606505",
            "telephone_number": "949-760-9222",
            "fax_number": "949-644-4312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISKILA",
        "first_name": "NATHAN",
        "middle_name": "ARON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A104532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.