Beverly Mikuriya, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G27264 Issued in CA

Practice address

2968 State Highway 49 Ste C
Cool, CA 95614-9478

Phone

(530) 888-9020

Fax

(530) 888-9030

NPI assigned

Jul 31, 2006

Last updated

Aug 17, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 Care Specialist LLC

  • Internal Medicine Physician
  • West Chester, PA
  • NPI 1295764843
  NPD
• Burholme Emergency Care Specialists LLC

  • Emergency Medicine Physician
  • Philadelphia, PA
  • NPI 1588693121
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660694400000",
    "number": "1508872722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2968 STATE HIGHWAY 49",
            "city": "COOL",
            "state": "CA",
            "postal_code": "956149477",
            "telephone_number": "530-888-9020",
            "fax_number": "530-888-9030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2968 STATE HIGHWAY 49 STE C",
            "city": "COOL",
            "state": "CA",
            "postal_code": "956149478",
            "telephone_number": "530-888-9020",
            "fax_number": "530-888-9030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKURIYA",
        "first_name": "BEVERLY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G27264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009373400001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kara Lese Kreutz, SLP
• Yvonne Lewald
• Ardelle Lucille Libby, PHARM.D.
• Franklin Dale Lieberman, PHD
• Pamela Joy Maggiacomo, RPT,LMT
• Thomas Riggio, O.D.
• Samuel Peter Rydell, PHARMD
• Justine Lorina Scott
• Wigbert Sy
• Thomas M. Clements, DDS, Inc. (Cool Family Dentistry)

• Internal Medicine Physician in Cool, CA
• Providers in Cool, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.