Individual provider Active NPI

Kurt S. Kusserow, MD

  • Emergency Medicine Physician
  • Davis, CA
National Provider Identifier
1326156878
Registry record updated Mar 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A91540 Issued in CA
Practice address
2000 Sutter Place
Davis, CA 95616-6201
Phone
(530) 756-6440
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A91540 CA Primary

Addresses

Primary practice location

2000 Sutter Place
Davis, CA 95616-6201

Mailing address

P.O. Box 12020
Westminster, CA 92685-2020
Phone (888) 556-5613

Other identifiers 1

IdentifierTypeStateIssuer
00A915400MedicaidCA

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
I20050804001040 CA Practitioner - Emergency Medicine 4284608860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A91540CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America-California Emergency Medicine CurrentSince Apr 1, 2011 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Apr 1, 2011 Accepting new patients

Locations

2000 Sutter Pl
Davis, CA 95616
Phone (530) 756-6440

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1650 Creekside Dr
Folsom, CA 95630
Phone (916) 983-7400

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

2801 L St
Sacramento, CA 95816
Phone (916) 454-2222

Interoperability endpoints

  • Direct secure messaging: kkusserowmd35345@hisp.ehr.sutterhealth.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299456000000",
    "number": "1326156878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 12020",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926852020",
            "telephone_number": "888-556-5613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 SUTTER PLACE",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956166201",
            "telephone_number": "530-756-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSSEROW",
        "first_name": "KURT",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2011-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A91540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A915400",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis, CA

Sources for this page

Verify at the official NPI Registry.