Individual provider Active NPI

Matthew Steven Kook

  • Certified Registered Nurse Anesthetist
  • Pasadena, CA
National Provider Identifier
1255033973
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
143030 Issued in CA
Practice address
75 W Holly St
Pasadena, CA 91103-3946
Phone
(562) 457-9574
NPI assigned
Mar 17, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 844452 CA
Certified Registered Nurse Anesthetist 367500000X 143030 CA Primary

Addresses

Primary practice location

75 W Holly St
Pasadena, CA 91103-3946

Mailing address

75 W Holly St
Pasadena, CA 91103-3946

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230531002849 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628435906 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orange Coast Anesthesia IncGroup PAC ID 2466613591, 85 clinicians
Precision Anesthesia Group IncGroup PAC ID 6204145105, 14 clinicians

Practice addresses (Care Compare)

1420 S Central Ave
Glendale, CA 91204-2508
Phone (818) 502-1900

450 N Roxbury Dr
Suite 600
Beverly Hills, CA 90210-4225
Phone (310) 651-2050

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
75.51
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
844452CAMDEmergency Registered Nurse
143030CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Buena Vista Anesthesia Medical Group CurrentSince May 23, 2023 Accepting new patients
Precision Anesthesia Group Inc CurrentSince Nov 1, 2023 Accepting new patients
Orange Coast Anesthesia Inc CurrentSince Dec 1, 2024 Accepting new patients

Locations

450 N Roxbury Dr
Ste 600
Beverly Hills, CA 90210
Phone (310) 651-2050

9735 Wilshire Blvd
Ste 100
Beverly Hills, CA 90212
Phone (310) 601-3900

9375 Wilshire Blvd Ste 100
Beverly Hills, CA 90210

450 N Roxbury Dr
Ste 240
Beverly Hills, CA 90210
Phone (310) 651-2040

120 S Spalding Dr
Ste 120
Beverly Hills, CA 90212
Phone (310) 601-3900

501 S Buena Vista St
Burbank, CA 91505
Phone (818) 783-0800

1420 S Central Ave
Glendale, CA 91204
Phone (818) 502-1900

1801 W Olympic Blvd
#2100
Pasadena, CA 91199

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

Organizations & group practices 3

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 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": "1679011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1255033973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 W HOLLY ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911033946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 W HOLLY ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911033946",
            "telephone_number": "562-457-9574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOK",
        "first_name": "MATTHEW",
        "middle_name": "STEVEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-17",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "CA",
            "license": "844452",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "143030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.