Kosuke Ken Iwaki, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A162107 Issued in CA

Practice address

1303 E Herndon Ave
Fresno, CA 93720

Phone

(559) 450-5611

Fax

(559) 450-7470

NPI assigned

May 17, 2016

Sex

Male

Sole proprietor

No

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, NY2 enrollments

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 2

Specialty

Internal Medicine

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Icahn School of Medicine at Mount SinaiGroup PAC ID 8224282926, 317 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elmhurst Hospital Center Hospital, Elmhurst, NY, CCN 330128

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722

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.

• Icahn School of Medicine at Mount Sinai

  • Orthopaedic Surgery Physician
  • Elmhurst, NY
  • NPI 1609120674
  Medicare reassignment Care Compare group NPD
• Saint Agnes Medical Foundation

  • Internal Medicine Physician
  • Fresno, CA
  • NPI 1558819482
  Medicare reassignment NPD
• LQMG Medical Group Inc.

  • Internal Medicine Physician
  • Fresno, CA
  • NPI 1437166360
  NPD
• Icahn School of Medicine at Mount Sinai

  • Anesthesiology Physician
  • Elmhurst, NY
  • NPI 1063766038
  NPD
• Icahn School of Medicine at Mount Sinai

  • Surgery Physician
  • Elmhurst, NY
  • NPI 1073867040
  NPD
• Icahn School of Medicine at Mount Sinai

  • Internal Medicine Physician
  • Elmhurst, NY
  • NPI 1184977324
  NPD
• Icahn School of Medicine at Mount Sinai

  • Cardiovascular Disease Physician
  • Elmhurst, NY
  • NPI 1417201484
  NPD
• Icahn School of Medicine at Mount Sinai

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Elmhurst, NY
  • NPI 1437403409
  NPD
• Icahn School of Medicine at Mount Sinai

  • Pediatrics Physician
  • Elmhurst, NY
  • NPI 1518211580
  NPD
• Icahn School of Medicine at Mount Sinai

  • Obstetrics & Gynecology Physician
  • Elmhurst, NY
  • NPI 1578817540
  NPD
• Icahn School of Medicine at Mount Sinai

  • Diagnostic Radiology Physician
  • Elmhurst, NY
  • NPI 1619221686
  NPD
• Icahn School of Medicine at Mount Sinai

  • Internal Medicine Physician
  • Elmhurst, NY
  • NPI 1689928657
  NPD

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

• New York City Health and Hospitals Corporation

  • General Acute Care Hospital
  • Elmhurst, NY
  • NPI 1063426377
  Care Compare affiliation

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1386091585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 E HERNDON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203309",
            "telephone_number": "559-450-5611",
            "fax_number": "559-450-7470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 E HERNDON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93720",
            "telephone_number": "559-450-5611",
            "fax_number": "559-450-7470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 Woodward Ave Apt 1L",
            "address_purpose": "LOCATION",
            "city": "Ridgewood",
            "state": "NY",
            "postal_code": "113851540",
            "country_code": "US",
            "telephone_number": "917-769-4447",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1303 E Herndon Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "93720",
            "country_code": "US",
            "telephone_number": "559-450-5611",
            "fax_number": "559-450-7470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IWAKI",
        "first_name": "KOSUKE",
        "middle_name": "KEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-17",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A162107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vera Ivanova, RN
• Marshai Iverson
• Crystal Marie Ives Tallman, M.D.
• Ivna Home Care Services Inc
• Gordon N Iwahashi, NCMMT
• Iwata Nursing Anesthesia Services Inc
• Eriko Iwata, CRNA
• Emmanuella O Iwebor, FNP
• Melissa Iwo, MS
• Bala Chidambaram Iyer, MD

• Internal Medicine Physician in Fresno, CA
• Providers in Fresno, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; 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.