Individual provider Active NPI

Elizabeth Kurkjian, MD

  • Obstetrics & Gynecology Physician
  • Fremont, CA
National Provider Identifier
1598727414
Registry record updated Mar 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G80516 Issued in CA
Practice address
2299 Mowry Ave
#3C
Fremont, CA 94538-1621
Phone
(510) 796-7057
Fax
(510) 796-5198
NPI assigned
Apr 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X G80516 CA Primary

Addresses

Primary practice location

2299 Mowry Ave
#3C
Fremont, CA 94538-1621

Mailing address

2299 Mowry Ave
#3C
Fremont, CA 94538-1621
Phone (510) 796-7057

Other identifiers 1

IdentifierTypeStateIssuer
00G80516MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20081204000805 CA Practitioner - Obstetrics/Gynecology 6305907759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.74 of 100Reported as group
Quality
66.48
Promoting interoperability
100
Improvement activities
40
Cost
75.97

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G80516CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Township Medical Foundation CurrentSince Jul 1, 2011 Accepting new patients
Washington Township Medical Foundation Obstetrics & Gynecology CurrentSince Jul 1, 2011 Accepting new patients
Washington Township Medical Group Past Accepting new patients

Locations

39500 Fremont Blvd
Ste 100
Fremont, CA 94538
Phone (510) 248-1800

2299 Mowry Ave
Ste 3C
Fremont, CA 94538
Phone (510) 248-1470

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236556800000",
    "number": "1598727414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2299 MOWRY AVE",
            "address_2": "#3C",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381621",
            "telephone_number": "510-796-7057",
            "fax_number": "510-796-5198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2299 MOWRY AVE",
            "address_2": "#3C",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381621",
            "telephone_number": "510-796-7057",
            "fax_number": "510-796-5198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURKJIAN",
        "first_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2009-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G80516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G80516",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.