Individual provider Active NPI

Lea Kiku Matsuoka, MD

  • Transplant Surgery Physician
  • Sacramento, CA
National Provider Identifier
1609046069
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Transplant Surgery PhysicianTaxonomy code 204F00000X
License
A86822 Issued in CA
Practice address
2335 Stockton Blvd
Sacramento, CA 95817-2201
Phone
(310) 989-1806
NPI assigned
Mar 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Transplant Surgery Physician 204F00000X 56163 TN
Surgery Physician 208600000X A86822 CA
Transplant Surgery Physician 204F00000X A86822 CA Primary

Addresses

Primary practice location

2335 Stockton Blvd
Sacramento, CA 95817-2201

Mailing address

2335 Stockton Blvd
Sacramento, CA 95817-2201
Phone (310) 989-1806

Other identifiers 2

IdentifierTypeStateIssuer
00A868220OtherCABLUE SHIELD PROVIDER NUMBER
00A868220MedicaidCA

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
I20050923000613 CA Practitioner - General SurgeryPractitioner - Other (Physician) 0345274833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Southern California Keck School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

2221 Stockton Blvd
Sacramento, CA 95817-1418
Phone (916) 734-3761

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
64.8
Promoting interoperability
100
Improvement activities
40
Cost
68.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
86822CAMDPharmacist
A86822CAMDTransplant Surgery Physician
56163TNMDTransplant Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca CurrentSince May 17, 2023 Accepting new patients
Regents of the Univ of Ca Transplant Surgery CurrentSince May 17, 2023 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Vanderbilt Univ. Medical Center Past Accepting new patients
Huntington Hospital Association Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients
Usc Surgeons, Inc. Surgery Past Accepting new patients
Regents of the Univ of Ca Surgery Past Accepting new patients
Childrens Hospital of Los Angeles Past Accepting new patients
Keck Medical Center of Usc Past Accepting new patients

Locations

2221 Stockton Blvd
Ste B
Sacramento, CA 95817
Phone (916) 734-2111

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

4868 X St
Sacramento, CA 95817
Phone (916) 703-1503

2221 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-2680

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1204329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1609046069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2335 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172201",
            "telephone_number": "310-989-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2335 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172201",
            "telephone_number": "310-989-1806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSUOKA",
        "first_name": "LEA",
        "middle_name": "KIKU",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-01",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "TN",
            "license": "56163",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A86822",
            "primary": false
        },
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "CA",
            "license": "A86822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER NUMBER",
            "identifier": "00A868220",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A868220",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.