Individual provider Active NPI

Kyla Nighohossian, M.D.

  • Psychiatry Physician
  • Oakland, CA
National Provider Identifier
1316328982
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A174526 Issued in CA
Practice address
6366 Sunnymere Ave
Oakland, CA 94605-2266
Phone
(618) 334-6585
NPI assigned
Jun 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 125067161 IL
Psychiatry Physician 2084P0800X A174526 CA Primary

Addresses

Primary practice location

6366 Sunnymere Ave
Oakland, CA 94605-2266

Mailing address

6366 Sunnymere Ave
Oakland, CA 94605-2266
Phone (618) 334-6585

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
I20240919002517 CA Practitioner - Psychiatry 0244543577 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Southern Illinois University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Contra Costa CountyGroup PAC ID 8628052974, 74 clinicians
Hiawatha Harris MD Inc.Group PAC ID 1052580115, 12 clinicians

Practice addresses (Care Compare)

13585 San Pablo Ave
FL 2
San Pablo, CA 94806-3804
Phone (510) 942-4700

1700 Broadway
Suite 500
Oakland, CA 94612-2141
Phone (510) 273-4200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A174526CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hiawatha Harris, M.D., Inc. CurrentSince Aug 6, 2024 Accepting new patients
Hiawatha Harris, Corporation CurrentSince Aug 6, 2024 Accepting new patients
Hiawatha Harris, M.D., Inc. Current Accepting new patients

Locations

1700 Broadway
#500
Oakland, CA 94612
Phone (510) 273-4200

5674 Stoneridge Dr
Ste 207
Pleasanton, CA 94588

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1316328982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6366 SUNNYMERE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946052266",
            "telephone_number": "618-334-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6366 SUNNYMERE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946052266",
            "telephone_number": "618-334-6585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIGHOHOSSIAN",
        "first_name": "KYLA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-09",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "125067161",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A174526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.