Individual provider Active NPI

Kenneth A Ikemiya, MD

  • Anesthesiology Physician
  • Fresno, CA
National Provider Identifier
1396777801
Registry record updated Sep 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G70297 Issued in CA
Practice address
1303 E Herndon Ave
Fresno, CA 93720-3309
Phone
(559) 450-3000
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G70297 CA Primary

Addresses

Primary practice location

1303 E Herndon Ave
Fresno, CA 93720-3309

Mailing address

7417 N Cedar Ave
Fresno, CA 93720-3637
Phone (559) 436-0871

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
I20090416000218 CA Practitioner - AnesthesiologyPractitioner - Other (Physician) 7517936271 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Consultants of FresnoGroup PAC ID 8527967082, 64 clinicians

Practice addresses (Care Compare)

1303 E Herndon Ave
Fresno, CA 93720-3309

1360 E Spruce Ave
Suite 101a
Fresno, CA 93720-3378
Phone (559) 437-5645

Hospital & facility affiliations

  • Fresno Surgical Hospital Hospital, Fresno, CA, CCN 050708
  • Saint Agnes Medical Center Hospital, Fresno, CA, CCN 050093

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G70297CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Home Health Services CurrentSince Jan 26, 2009 Accepting new patients
Saint Agnes Medical Center CurrentSince Jan 26, 2009 Accepting new patients

Locations

1360 E Herndon Ave
Fresno, CA 93720
Phone (559) 449-5010

1303 E Herndon Ave
Fresno, CA 93720
Phone (559) 449-3000

7417 N Cedar Ave
Ste 101
Fresno, CA 93720
Phone (559) 437-5645

1105 E Spruce Ave
Ste 100
Fresno, CA 93720
Phone (559) 450-7300

1630 E Herndon Ave
Ste 100
Fresno, CA 93720
Phone (559) 449-2888

7014 N Whitney Ave
Ste B
Fresno, CA 93720
Phone (559) 321-2900

7417 N Cedar Ave
Fresno, CA 93720
Phone 5594360871111

Organizations & group practices 3

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 2

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316563200000",
    "number": "1396777801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7417 N CEDAR AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203637",
            "telephone_number": "559-436-0871",
            "fax_number": "559-436-5221"
        },
        {
            "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": "937203309",
            "telephone_number": "559-450-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKEMIYA",
        "first_name": "KENNETH",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2011-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G70297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.