NPIMap

Individual provider Active NPI

Kenneth P Tway

  • Cardiovascular Disease Physician
  • San Luis Obispo, CA
National Provider Identifier
1396924189
Registry record updated Oct 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
G39105 Issued in CA
Practice address
1106 Pacific St
San Luis Obispo, CA 93401-3302
Phone
(805) 546-9500
Fax
(805) 546-9699
NPI assigned
Oct 29, 2007
Last updated
Oct 29, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X G39105 CA Primary
Interventional Cardiology Physician 207RI0011X G39105 CA

Addresses

Primary practice location

1106 Pacific St
San Luis Obispo, CA 93401-3302

Mailing address

1106 Pacific St
San Luis Obispo, CA 93401-3302
Phone (805) 546-9500

Other identifiers 1

IdentifierTypeStateIssuer
00G391050MedicaidCA

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
I20071219000741 CA Practitioner - Cardiovascular Disease (Cardiology) 7719077304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Southern California Keck School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1106 Pacific St
San Luis Obispo, CA 93401-3302
Phone (805) 546-9500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.58 of 100Reported as individual
Quality
89.98
Improvement activities
40
Cost
88.63

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G39105CAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kenneth P. Tway, M.D., F.a.C.C., Inc. Cardiovascular Disease CurrentSince Oct 29, 2007 Accepting new patients
Doctors Medical Center of Modesto, Inc. Past Accepting new patients
Twin Cities Community Hospital, Inc. Past Accepting new patients
Dignity Health Past Accepting new patients
Dignity Community Care Past Accepting new patients

Locations

1106 Pacific St
Sn Luis Obisp, CA 93401
Phone (805) 546-9500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13554/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kenneth.tway.1@13554.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1193616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193616000000",
    "number": "1396924189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 PACIFIC ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013302",
            "telephone_number": "805-546-9500",
            "fax_number": "805-546-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 PACIFIC ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013302",
            "telephone_number": "805-546-9500",
            "fax_number": "805-546-9699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TWAY",
        "first_name": "KENNETH",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-29",
        "last_updated": "2007-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G39105",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "G39105",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G391050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.