Individual provider Active NPI

Davis Kipkemboi Kimaiyo, MD

  • Cardiovascular Disease Physician
  • San Francisco, CA
National Provider Identifier
1336775279
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A192030 Issued in CA
Practice address
535 Mission Bay Blvd S
San Francisco, CA 94143-2156
Phone
(415) 353-2873
Fax
(415) 353-2528
NPI assigned
Mar 22, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A192030 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

535 Mission Bay Blvd S
San Francisco, CA 94143-2156

Mailing address

211 S Beach Blvd SPC 98
Anaheim, CA 92804-1840
Phone (714) 650-4298

Other practice location 1

211 S Beach Blvd Spc 98
Anaheim, CA 92804-1840
Phone (714) 650-4298

Other practice location 2

55 Fruit St
Boston, MA 02114-2621
Phone (617) 726-2000

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
I20260625001797 CA Practitioner - Cardiovascular Disease (Cardiology) 6204247620 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of California, Geffen School of Medicine, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

490 Illinoi St 6TH Floor RM
600A 6TH Floor
San Francisco, CA 94143

490 Illinois St
FL 6
San Francisco, CA 94143-2510

535 Mission Bay Blvd S
San Francisco, CA 94143-2156

National Provider Directory

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1584835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1336775279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 S BEACH BLVD SPC 98",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928041840",
            "telephone_number": "714-650-4298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 MISSION BAY BLVD S",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432156",
            "telephone_number": "415-353-2873",
            "fax_number": "415-353-2528"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 S Beach Blvd Spc 98",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928041840",
            "country_code": "US",
            "telephone_number": "714-650-4298",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Fruit St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142621",
            "country_code": "US",
            "telephone_number": "617-726-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMAIYO",
        "first_name": "DAVIS",
        "middle_name": "KIPKEMBOI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-22",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A192030",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.