Michael Dennis Kifune, MD
Individual provider Active NPI Family Medicine Physician · San Andreas, CA
NPI 1578568614 · NPPES record last updated Sep 24, 2014
Key facts
- NPI
- 1578568614
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- G39833 (CA)
- Practice address
- 1333 Highway 49
San Andreas, CA 95249-9618 - Phone
- (209) 755-1400
- Fax
- (209) 755-1430
- NPI assigned
- Jun 16, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 19
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of California, Irvine, California College of Medicine, 1978
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mark Twain Medical Center
Practice addresses (Care Compare)
2182 Hwy 4
Suite A100
Arnold, CA 95223-7281
Phone (209) 754-9232
590 Stanislaus Ave
Angels Camp, CA 95222-9355
Phone (209) 736-0813
Hospital & facility affiliations
- Iron Point Home Health Care Inc
- Adventist Health Home Care Services
- Careone Home Health and Hospice, Inc
- United Home Care of Northern California
- Atta Home Healthcare
- Mark Twain Medical Center
- Adventist Health Sonora
- Sutter Amador Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090120000153 | CA | Practitioner - Family Practice |
2264435767 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G39833 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark Twain Medical Center | Current |
Accepting new patients | |
| Sandra J. Shetzline, DO Inc | Family Medicine | Past | Accepting new patients |
Locations
2182 Hwy 4
Ste A
Arnold, CA 95223
2182 Hwy 4
Ste A100
Arnold, CA 95223
Phone (209) 754-9232
430 Sawmill Creek Rd
Copperopolis, CA 95228
Phone (209) 785-0000
12140 New York Ranch Rd
Jackson, CA 95642
Phone (209) 257-2400
702 Mountain Ranch Rd
San Andreas, CA 95249
Phone (209) 754-0870
768 Mountain Ranch Rd
San Andreas, CA 95249
Phone (209) 464-6422
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G39833 | CA | Yes |
Addresses
Primary practice location
1333 Highway 49
San Andreas, CA 95249-9618
Mailing address
PO Box 939
Angels Camp, CA 95222-0939
Phone (209) 754-6240
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G398330 | Medicaid | CA |
Other providers in San Andreas, CA
- Karen Karam
- Denise L Keiser
- Dean Matthew Kelaita
- Shannon Kelaita
- Christine Jan Khan
- Lee Kimball
- Regina Elizabeth King
- Marin Koorkoff
- Matthew Joshua King-Lung Kor
- Kathryn Krayk
All providers in San Andreas, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.