NPIMap

Individual provider Active NPI

Ivan Alexandre De Kouchkovsky

  • Medical Oncology Physician
  • San Francisco, CA
National Provider Identifier
1245692839
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
A152456 Issued in CA
Practice address
505 Parnassus Ave
Internal Medicine Residency Program
San Francisco, CA 94143-2204
Phone
(415) 476-1529
NPI assigned
Mar 23, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X A152456 CA Primary

Addresses

Primary practice location

505 Parnassus Ave
Internal Medicine Residency Program
San Francisco, CA 94143-2204

Mailing address

505 Parnassus Ave
Internal Medicine Residency Program
San Francisco, CA 94143-2204
Phone (415) 476-1529

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220831002801 CA Practitioner - Hematology/OncologyPractitioner - Internal Medicine 1759786593 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
New York University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UCSF Medical Group Business ServicesGroup PAC ID 3779497870, 1,533 clinicians

Practice addresses (Care Compare)

225 California Dr
Burlingame, CA 94010-4145
Phone (650) 341-9131

2330 Post St
San Francisco, CA 94115-3465
Phone (415) 476-4029

3100 San Pablo Ave
Berkeley, CA 94702-2498
Phone (510) 985-5020

400 Parnassus Ave
San Francisco, CA 94143-2202

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.01 of 100Reported as group
Quality
86.78
Improvement activities
40
Cost
70.46

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
95
Improvement activities
40
Cost
80.65

Merit-based Incentive Payment System (MIPS)

Final score
84.89 of 100Reported as group
Quality
81.13
Improvement activities
40
Cost
71.5

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A152456CAMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Medical Group Business Services Medical Oncology CurrentSince Jun 30, 2022 Accepting new patients
University of California San Francisco CurrentSince Jun 30, 2022 Accepting new patients
Regents of the University of California Medical Oncology CurrentSince Jun 30, 2022 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jun 30, 2022 Accepting new patients
University of California San Francisco Current Accepting new patients
University of California San Francisco CurrentSince Jun 30, 2022 Accepting new patients
Regents of the University of California Past Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

505 Parnassus Ave
#M1286
San Francisco, CA 94143
Phone (415) 476-0584

2001 The Embarcadero
Ofc Of
San Francisco, CA 94143
Phone (628) 224-5503

1825 4th St
Fl Sixth
San Francisco, CA 94143
Phone (415) 885-3882

1825 4th St
Fl 6
San Francisco, CA 94143
Phone (415) 353-7337

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1245692839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 PARNASSUS AVE",
            "address_2": "INTERNAL MEDICINE RESIDENCY PROGRAM",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432204",
            "telephone_number": "415-476-1529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 PARNASSUS AVE",
            "address_2": "INTERNAL MEDICINE RESIDENCY PROGRAM",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432204",
            "telephone_number": "415-476-1529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE KOUCHKOVSKY",
        "first_name": "IVAN",
        "middle_name": "ALEXANDRE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-23",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "CA",
            "license": "A152456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.