Mia Matsuda Kanak, MD, MPH

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A154810 Issued in CA

Practice address

525 E 68TH St # 179
New York, NY 10065-4870

Phone

(866) 463-2778

NPI assigned

Apr 5, 2015

Last updated

Sep 30, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Emergency Medicine

Education

Stanford University School of Medicine, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmk4006@direct.nyp.org

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.

• Weill Medical College of Cornell

  dba Cornell University Medical College ECG

  • Cardiovascular Disease Physician
  • New York, NY
  • NPI 1245355270
  Medicare reassignment NPD
• Weill Medical College of Cornell

  • Cardiovascular Disease Physician
  • New York, NY
  • NPI 1144729385
  NPD
• Weill Medical College of Cornell

  dba Cornell Emer.Dept.Phsyicians

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1205882586
  NPD
• Children's Hospital Los Angeles Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Los Angeles, CA
  • NPI 1265530653

  Pediatrics

  NPD
• Child Health Foundation of Boston, Inc.

  • Pediatrics Physician
  • Boston, MA
  • NPI 1619969920
  NPD (past)

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

{
    "created_epoch": "1428192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1508251687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST # 179",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654870",
            "telephone_number": "866-463-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST # 179",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654870",
            "telephone_number": "866-463-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANAK",
        "first_name": "MIA",
        "middle_name": "MATSUDA",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-05",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A154810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "525 E 68th St # 179",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100654870",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmk4006@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "525 E 68th St # 179",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100654870",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "525 E 68th St # 179",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100654870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Julia Angela Kamuda, PHARM.D.
• Jiusong Kan, L.AC.
• Karen Chang Kan, M.D.
• Tina J Kana
• Sai Gautham Kanagala
• Aria Kanakaris
• Geetha Kanakeswaran, M.D.
• Amr Kanan
• Saad Kanan
• Anxhela Kanani

• Pediatrics Physician in New York, NY
• Providers in New York, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.