Individual provider Active NPI

Kevin Eugene Kumagai

  • Audiologist
  • Riverside, CA
National Provider Identifier
1619145174
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AU2578 Issued in CA
Practice address
7117 Brockton Ave
Riverside, CA 92506-2658
Phone
(951) 782-3887
Fax
(951) 784-5568
NPI assigned
Feb 18, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AU2578 CA Primary

Addresses

Primary practice location

7117 Brockton Ave
Riverside, CA 92506-2658

Mailing address

7117 Brockton Ave
Riverside, CA 92506-2658
Phone (951) 782-3887

Other identifiers 2

IdentifierTypeStateIssuer
AU2578OtherCAAUDIOLOGY LICENSE
ZZZ92058ZOtherCASITE LOCATION

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080408000936 CA Practitioner - Qualified Audiologist 2466539986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Medical Clinic IncGroup PAC ID 2961492327, 173 clinicians

Practice addresses (Care Compare)

7117 Brockton Ave
Riverside, CA 92506-2658
Phone (951) 683-6370

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AU2578CAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Medical Clinic, Inc Audiologist CurrentSince Jan 31, 2008 Accepting new patients
Riverside Medical Clinic, Inc Current Accepting new patients

Locations

6405 Day St
Riverside, CA 92507
Phone (909) 683-6370

3660 Arlington Ave
Riverside, CA 92506
Phone (951) 782-3789

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1203292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1619145174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7117 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062658",
            "telephone_number": "951-782-3887",
            "fax_number": "951-784-5568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7117 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062658",
            "telephone_number": "951-782-3887",
            "fax_number": "951-784-5568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAGAI",
        "first_name": "KEVIN",
        "middle_name": "EUGENE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-18",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "AU2578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AUDIOLOGY LICENSE",
            "identifier": "AU2578",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SITE LOCATION",
            "identifier": "ZZZ92058Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.