NPIMap

Individual provider Active NPI

Taylor A Konkin, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Chico, CA
National Provider Identifier
1386783884
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
A97741 Issued in CA
Practice address
131 Raley Blvd
Chico, CA 95928-8347
Phone
(530) 897-4500
Fax
(530) 897-4544
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X A97741 CA
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X A97741 CA Primary

Addresses

Primary practice location

131 Raley Blvd
Chico, CA 95928-8347

Mailing address

131 Raley Blvd
Chico, CA 95928-8347
Phone (530) 897-4500

Other identifiers 1

IdentifierTypeStateIssuer
00A977410MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address taylor.konkin.1@5678.direct.athenahealth.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071110000188 CA Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 3971552233 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
Loma Linda University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

131 Raley Blvd
Chico, CA 95928-8347
Phone 5308974500128

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.44 of 100Reported as individual
Quality
76.76
Promoting interoperability
100
Improvement activities
40
Cost
88.04

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement31
Knee replacement38
Lower limb (leg) arthroscopy (minimally invasive joint repair)27
Upper limb (arm) arthroscopy (minimally invasive joint repair)102

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A97741CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Enloe Medical Center CurrentSince Feb 13, 2015 Accepting new patients
Enloe Medical Center Orthopaedic Surgery CurrentSince Feb 13, 2015 Accepting new patients
Emergency Physicians of Indiana PC Past Accepting new patients

Locations

1600 Esplanade
Ste C
Chico, CA 95926
Phone (530) 332-4470

1390 E Lassen Ave
Chico, CA 95973
Phone (530) 332-6332

Interoperability endpoints

  • Direct secure messaging: tkonkin15303@enloedirect.org
  • FHIR API: https://api.platform.athenahealth.com/5678/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 7

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1386783884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 RALEY BLVD",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959288347",
            "telephone_number": "530-897-4500",
            "fax_number": "530-897-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 RALEY BLVD",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959288347",
            "telephone_number": "530-897-4500",
            "fax_number": "530-897-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONKIN",
        "first_name": "TAYLOR",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A97741",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "A97741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A977410",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "taylor.konkin.1@5678.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "system-generated address that providers use for the secure transfer of files containing clinical data",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Files that are transferred through a provider's Direct address will appear in their Clinical Inbox",
            "address_1": "131 Raley Blvd",
            "city": "Chico",
            "state": "CA",
            "country_code": "US",
            "postal_code": "959288347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

Verify at the official NPI Registry.