Active NPI
Matthew James Takeuchi, DPM
- Foot & Ankle Surgery Podiatrist
- Stockton, CA
National Provider Identifier
1336306224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- E4904
- Practice address
- 2488 N California St
Stockton, CA 95204-5508 - Phone
- (209) 948-3333
- Fax
- (209) 948-2665
- NPI assigned
- May 19, 2008
- Last updated
- Jan 6, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | E4904 | CA | Primary |
Addresses
Primary practice location
2488 N California St
Stockton, CA 95204-5508
Mailing address
2488 N California St
Stockton, CA 95204-5508
Phone (209) 948-3333
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672963200000",
"number": "1336306224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2488 N CALIFORNIA ST",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952045508",
"telephone_number": "209-948-3333",
"fax_number": "209-948-2665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2488 N CALIFORNIA ST",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952045508",
"telephone_number": "209-948-3333",
"fax_number": "209-948-2665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAKEUCHI",
"first_name": "MATTHEW",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-19",
"last_updated": "2023-01-06",
"certification_date": "2023-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "CA",
"license": "E4904",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "7373 West Ln",
"city": "Stockton",
"state": "CA",
"country_code": "US",
"postal_code": "952103377",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.