Active NPI
Kei Nagatomo, D.O.
- Surgery Physician
- Phoenix, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 009874
- Practice address
- 16601 N 40TH St Ste 204
Phoenix, AZ 85032-3356 - Phone
- (602) 996-4747
- Fax
- (602) 953-5466
- NPI assigned
- May 21, 2013
- Last updated
- Dec 2, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | OT015332 | PA | |
| Surgery Physician | 208600000X | 324498 | LA | |
| Surgery Physician | 208600000X | 009874 | AZ | Primary |
Addresses
Primary practice location
16601 N 40TH St Ste 204
Phoenix, AZ 85032-3356
Mailing address
16601 N 40TH St Ste 204
Phoenix, AZ 85032-3356
Phone (602) 996-4747
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- At Still University of Health Sciences, College of Osteo Med, Kirksville, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
16601 N 40TH St
Suite 204
Phoenix, AZ 85032-3356
Phone (602) 996-4747
Hospital & facility affiliations
- Abrazo Central Campus
- Honor Health John C. Lincoln Medical Center
- Honorhealth Scottsdale Thompson Peak Med Ctr
- Honorhealth Deer Valley Medical Center
- Honorhealth Scottsdale Shea Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Removal of tissue | 11 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Surgical Clinics, LTD | Current | Accepting new patients | |
| Lankenau Medical Center | Past | Accepting new patients |
Locations
16601 N 40th St
Ste 204
Phoenix, AZ 85032
Phone (602) 633-3721
2000 W Bethany Home Rd
Phoenix, AZ 85015
Phone (480) 209-4000
6036 N 19th Ave
Ste 208
Phoenix, AZ 85015
Phone (480) 896-9888
Interoperability endpoints
- keinagatomo@vsc.allscriptsdirect.net
- kena4417@yourcarecommunity.org
Organizations & group practices 2
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.
-
- Surgery Physician
- Phoenix, AZ
- NPI 1962440602
-
- General Acute Care Hospital
- Wynnewood, PA
- NPI 1033558671
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba HonorHealth Scottsdale Shea Medical Center
- General Acute Care Hospital
- Scottsdale, AZ
- NPI 1386608859
-
dba HonorHealth Scottsdale Thompson Peak Medical Center
- General Acute Care Hospital
- Scottsdale, AZ
- NPI 1417152745
-
dba HonorHealth Deer Valley Medical Center
- General Acute Care Hospital
- Phoenix, AZ
- NPI 1528169125
-
dba HonorHealth John C. Lincoln Medical Center
- General Acute Care Hospital
- Phoenix, AZ
- NPI 1770690695
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669939200000",
"number": "1255777934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16601 N 40TH ST STE 204",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850323356",
"telephone_number": "602-996-4747",
"fax_number": "602-953-5466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16601 N 40TH ST STE 204",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850323356",
"telephone_number": "602-996-4747",
"fax_number": "602-953-5466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAGATOMO",
"first_name": "KEI",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-21",
"last_updated": "2022-12-02",
"certification_date": "2022-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "PA",
"license": "OT015332",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "LA",
"license": "324498",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "AZ",
"license": "009874",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.