Active NPI
Kayoko Kifuji, M.D.
- Specialist
- Boston, MA
National Provider Identifier
1417910241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 155248
- Practice address
- 750 Washington St
Box# 1007
Boston, MA 02111-1526 - Phone
- (617) 636-8877
- Fax
- (617) 636-8442
- NPI assigned
- Apr 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 155248 | MA | Primary |
Addresses
Primary practice location
750 Washington St
Box# 1007
Boston, MA 02111-1526
Mailing address
3 Tannery Brook Row
Unit #1
Somerville, MA 02144-2756
Phone (617) 764-5068
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3199517 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 155248 | MA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194566400000",
"number": "1417910241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 TANNERY BROOK ROW",
"address_2": "UNIT #1",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021442756",
"telephone_number": "617-764-5068",
"fax_number": "617-764-5068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 WASHINGTON ST",
"address_2": "BOX# 1007",
"city": "BOSTON",
"state": "MA",
"postal_code": "021111526",
"telephone_number": "617-636-8877",
"fax_number": "617-636-8442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIFUJI",
"first_name": "KAYOKO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-11",
"last_updated": "2007-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MA",
"license": "155248",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3199517",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.