Kenichi T Miyata, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A117496 Issued in CA

Practice address

3393 G St
D
Merced, CA 95340-0964

Phone

(209) 230-9065

Fax

(209) 349-8511

NPI assigned

Feb 18, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

General Surgery

Education

University of Wisconsin School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Golden Valley Health CentersGroup PAC ID 4183527187, 114 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: kenichi.miyata.p1@direct.castle.nextgenshare.com

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.

• Golden Valley Health Centers

  • Federally Qualified Health Center (FQHC)
  • Turlock, CA
  • NPI 1356445753
  Medicare reassignment Care Compare group NPD
• Kenichi T. Miyata MD Inc

  • Surgery Physician
  • Merced, CA
  • NPI 1598108045
  Medicare reassignment Authorized official
• Camarena Health

  • Federally Qualified Health Center (FQHC)
  • Madera, CA
  • NPI 1891778114
  Medicare reassignment NPD
• Camarena Health

  • Federally Qualified Health Center (FQHC)
  • Los Banos, CA
  • NPI 1114757754
  NPD
• Camarena Health

  • Federally Qualified Health Center (FQHC)
  • Madera, CA
  • NPI 1174989297
  NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Manteca, CA
  • NPI 1477020121
  NPD
• Golden Valley Health Centers

  • Community/Retail Pharmacy
  • Merced, CA
  • NPI 1093817405
  NPD
• Dignity Health

  • General Acute Care Hospital
  • Merced, CA
  • NPI 1518018191
  NPD (past)
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
  • NPI 1487867503
  NPD (past)

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

{
    "created_epoch": "1171756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369699200000",
    "number": "1376687772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3393 G ST",
            "address_2": "D",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953400964",
            "telephone_number": "209-230-3065",
            "fax_number": "209-349-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3393 G ST",
            "address_2": "D",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953400964",
            "telephone_number": "209-230-9065",
            "fax_number": "209-349-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIYATA",
        "first_name": "KENICHI",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-18",
        "last_updated": "2013-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A117496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ranu M Mishra, DDS, M.S
• Jaideep Misra, MD
• Mission Gardens Facility
• Mission Merced Incorporated
• My-Leka Zsanae Mitchell
• Mobile-Med Work Health Solutions, Inc.
• Catherine Mobley
• Charity Mocklin
• Mari Lynn Mockus, NP
• Alok Modi, PHARMD

• Surgery Physician in Merced, CA
• Providers in Merced, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.