Individual provider Active NPI

Yuji Kitabatake, PA-C

  • Physician Assistant
  • Kearney, NE
National Provider Identifier
1356612030
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1635 Issued in NE
Practice address
2810 W 35TH St
Suite 1
Kearney, NE 68845-2909
Phone
(308) 865-2570
Fax
(308) 865-2508
NPI assigned
Jan 26, 2012
Last updated
Feb 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1635 NE Primary

Addresses

Primary practice location

2810 W 35TH St
Suite 1
Kearney, NE 68845-2909

Mailing address

2810 W 35TH St
Suite 1
Kearney, NE 68845-2909
Phone (308) 865-2570

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nolanmay@nwsmos.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120725000272 NE Practitioner - Physician Assistant 3476719188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New West Sports Medicine and Orthopaedic Surgery PCGroup PAC ID 6800861014, 12 clinicians

Practice addresses (Care Compare)

2810 W 35TH St
Kearney, NE 68845-2909

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.32 of 100Reported as group
Quality
56.65
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1635NEMDSpeech-Language Pathologist

Interoperability endpoints

  • Direct secure messaging: yuji.kitabatake.1@16664.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1327536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1356612030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 W 35TH ST",
            "address_2": "SUITE 1",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452909",
            "telephone_number": "308-865-2570",
            "fax_number": "308-865-2508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 W 35TH ST",
            "address_2": "SUITE 1",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452909",
            "telephone_number": "308-865-2570",
            "fax_number": "308-865-2508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITABATAKE",
        "first_name": "YUJI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-26",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nolanmay@nwsmos.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Direct Message Address for Supervising MD",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2810 W 35th St",
            "address_2": "Suite 1",
            "city": "Kearney",
            "state": "NE",
            "country_code": "US",
            "postal_code": "688452909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

Verify at the official NPI Registry.