Individual provider Active NPI

Kourosh Kojouri, MD

  • Surgery Physician
  • San Jose, CA
National Provider Identifier
1396821807
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A86065 Issued in CA
Practice address
260 International Cir
San Jose, CA 95119-1130
Phone
(408) 972-7000
NPI assigned
Oct 27, 2006
Last updated
Dec 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A86065 CA Primary

Addresses

Primary practice location

260 International Cir
San Jose, CA 95119-1130

Mailing address

1800 Harrison St FL 7
Oakland, CA 94612-3466
Phone (510) 625-6262

Other identifiers 1

IdentifierTypeStateIssuer
00A860650MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

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
I20040526000814 CA Practitioner - General Surgery 9739160763 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1800 Harrison St
Suite 7
Oakland, CA 94612-3463

1800 Harrison St 7TH FL
Oakland, CA 94612-3467

4000 Hollywood Blvd
Hollywood, FL 33021-1227

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A86065CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Surgery Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Oct 19, 2010 Accepting new patients
Berman Skin Institute Medical Group Inc CurrentSince Sep 1, 2023 Accepting new patients
Permanente Medical Group Inc Surgery CurrentSince Oct 19, 2010 Accepting new patients
Jill E. Stocker, D.O. PC PastSince May 22, 2010 Accepting new patients
Stanford Health Care Tri-Valley Past Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients

Locations

3581 Palmer Dr
Ste 203
Cameron Park, CA 95682
Phone (530) 676-0119

39465 Paseo Padre Pkwy
Ste 2600
Fremont, CA 94538
Phone (510) 456-2390

4300 El Camino Real
Ste 100
Los Altos, CA 94022
Phone (650) 325-6000

1800 Harrison St
Fl 7
Oakland, CA 94612

5575 W Las Positas Blvd
Ste 220
Pleasanton, CA 94588
Phone (650) 325-6000

5575 W Las Positas Blvd
Ste 230
Pleasanton, CA 94588
Phone (925) 416-1122

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

1792 Tribute Rd
Ste 200
Sacramento, CA 95815
Phone (916) 678-5400

1 Daniel Burnham Ct
Ste 350C
San Francisco, CA 94109
Phone (415) 771-6300

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

250 Hospital Pkwy
San Jose, CA 95119
Phone (408) 972-6320

260 International Cir
San Jose, CA 95119
Phone (408) 972-6335

260 International Cir
Ofc
San Jose, CA 95119

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

2160 W Grant Line Rd
Ste 210
Tracy, CA 95377
Phone (209) 229-7245

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

100 Pringle Ave
Ste 425
Walnut Creek, CA 94596
Phone (925) 932-3800

1166 Live Oak Blvd
Yuba City, CA 95991
Phone (530) 751-1500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kkojouri@directaddress.net

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1396821807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HARRISON ST FL 7",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123466",
            "telephone_number": "510-625-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 INTERNATIONAL CIR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951191130",
            "telephone_number": "408-972-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOJOURI",
        "first_name": "KOUROSH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A86065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A860650",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "250 Hospital Pkwy",
            "city": "San Jose",
            "state": "CA",
            "country_code": "US",
            "postal_code": "951191103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.