Individual provider Active NPI

Matthew Harrison Kanzler, MD

  • Dermatology Physician
  • Fremont, CA
National Provider Identifier
1629032271
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
G57056 Issued in CA
Practice address
3200 Kearney Street
Dermatology Department
Fremont, CA 94538-2299
Phone
(510) 490-1222
NPI assigned
Apr 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology Physician 207ND0900X G57056 CA
Procedural Dermatology Physician 207NS0135X G57056 CA
Dermatology Physician 207N00000X G57056 CA Primary

Addresses

Primary practice location

3200 Kearney Street
Dermatology Department
Fremont, CA 94538-2299

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (510) 498-2374

Other identifiers 1

IdentifierTypeStateIssuer
00G570560MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, HI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070423000461 CA Practitioner - Dermatology 5991800724 Reassigns benefits to 1 organization
I20241024003449 HI Practitioner - Dermatology 5991800724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Michigan Medical School, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hawaii Dermatology Centers IncGroup PAC ID 3274782586, 12 clinicians

Practice addresses (Care Compare)

4747 Kilauea Ave
Suite 104
Honolulu, HI 96816-5308
Phone (808) 218-7889

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions116
Removal or shaving of skin growth1-10
Skin biopsy19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G57056CAMDProcedural Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Jan 4, 1988 Accepting new patients
County of Santa Clara CurrentSince Jan 4, 1988 Accepting new patients
County of Santa Clara Current Accepting new patients
Hawaii Dermatology Centers, Inc CurrentSince Oct 1, 2024 Accepting new patients
G. Todd Bessinger, MD, PHD, LLC Dermatology PastSince Oct 1, 2024 Accepting new patients

Locations

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

1996 Lundy Ave
San Jose, CA 95131
Phone (408) 299-5846

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366

4747 Kilauea Ave
Ste 104
Honolulu, HI 96816
Phone (808) 218-7889

6700 Kalanianaole Hwy
Ste 217
Honolulu, HI 96825
Phone (808) 218-7889

970 N Kalaheo Ave
Ste C108
Kailua, HI 96734
Phone (800) 218-7889

407 Uluniu St
Ste 314
Kailua, HI 96734
Phone (808) 218-7889

Organizations & group practices 5

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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1629032271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "510-498-2374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 KEARNEY STREET",
            "address_2": "DERMATOLOGY DEPARTMENT",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382299",
            "telephone_number": "510-490-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANZLER",
        "first_name": "MATTHEW",
        "middle_name": "HARRISON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "G57056",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "G57056",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G57056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G570560",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.