NPIMap

Individual provider Active NPI

Brian Craig Kitamura, M.D.

  • Emergency Medicine Physician
  • Meridian, ID
National Provider Identifier
1235440132
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD165010 Issued in OR
Practice address
2963 E Copper Point Dr
Meridian, ID 83642-9055
Phone
(208) 322-1730
NPI assigned
Jun 24, 2010
Last updated
Jul 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X R72066 AZ
Emergency Medicine Physician 207P00000X M-12295 ID
Emergency Medicine Physician 207P00000X MD165010 OR Primary

Addresses

Primary practice location

2963 E Copper Point Dr
Meridian, ID 83642-9055

Mailing address

PO Box 5666
Denver, CO 80217-5666
Phone (866) 898-7136

Other practice location 1

3325 Pocahontas Rd
Baker City, OR 97814-1464
Phone (541) 523-1797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140723002260 ID Practitioner - Emergency Medicine 6608024229 Reassigns benefits to 1 organization
I20141021002639 OR Practitioner - Emergency Medicine 6608024229 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Nebraska College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2121

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M-12295IDMDEmergency Medicine Physician
R72066AZMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC Emergency Medicine CurrentSince Oct 3, 2017 Accepting new patients
Saint Alphonsus Medical Center Baker City, Inc CurrentSince Aug 1, 2022 Accepting new patients
Cep America, LLC Emergency Medicine CurrentSince Aug 1, 2016 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Aug 1, 2016 Accepting new patients
Cep America LLC Emergency Medicine Current Accepting new patients
Cep America, LLC Emergency Medicine Current Accepting new patients
Saint Alphonsus Medical Center Baker City, Inc CurrentSince Aug 1, 2022 Accepting new patients
Baker Clinic, LLP Current Accepting new patients
Emurgent Care PLLC Past Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

4300 E Flamingo Ave
Nampa, ID 83687
Phone (208) 205-1000

3325 Pocahontas Rd
Baker City, OR 97814
Phone (541) 523-1797

351 SW 9th St
Ontario, OR 97914
Phone (541) 881-7000

2801 St Anthony Way
Pendleton, OR 97801
Phone (541) 276-5121

2700 NW Stewart Pkwy
Roseburg, OR 97471
Phone (541) 673-0611

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1523/brand/1/csg/23/fhir/r4

Organizations & group practices 9

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.

Hospital & facility affiliations 8

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": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1235440132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5666",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802175666",
            "telephone_number": "866-898-7136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2963 E COPPER POINT DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429055",
            "telephone_number": "208-322-1730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3325 Pocahontas Rd",
            "address_purpose": "LOCATION",
            "city": "Baker City",
            "state": "OR",
            "postal_code": "978141464",
            "country_code": "US",
            "telephone_number": "541-523-1797",
            "fax_number": "541-523-1757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KITAMURA",
        "first_name": "BRIAN",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-24",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": "R72066",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "M-12295",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD165010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.