Individual provider Active NPI

Kenneth Kaushansky, M.D

  • Hematology & Oncology Physician
  • San Diego, CA
National Provider Identifier
1609834803
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
G86586 Issued in CA
Practice address
402 Dickinson St
Mail Code 8811 - Suite 380
San Diego, CA 92103-6902
Phone
(619) 543-6170
Fax
(619) 543-3931
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G86586 CA
Hematology & Oncology Physician 207RH0003X G86586 CA Primary

Addresses

Primary practice location

402 Dickinson St
Mail Code 8811 - Suite 380
San Diego, CA 92103-6902

Mailing address

336 Pine Needles Dr
Del Mar, CA 92014-3330
Phone (858) 793-1479

Other identifiers 1

IdentifierTypeStateIssuer
00G865860MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G86586CAMDHematology & Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1609834803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 PINE NEEDLES DR",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920143330",
            "telephone_number": "858-793-1479",
            "fax_number": "619-543-3931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 DICKINSON ST",
            "address_2": "MAIL CODE 8811 - SUITE 380",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921036902",
            "telephone_number": "619-543-6170",
            "fax_number": "619-543-3931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUSHANSKY",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G86586",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "G86586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G865860",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.