Individual provider Active NPI

Kristian Shinyu Gima, D.O.

  • General Practice Physician
  • Oakland, CA
National Provider Identifier
1629334032
Registry record updated May 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
20A13550 Issued in CA
Practice address
1438 3Rd St Unit B
Oakland, CA 94607-1806
Phone
(415) 606-1752
NPI assigned
Apr 10, 2012
Last updated
May 22, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 20A13550 CA Primary

Addresses

Primary practice location

1438 3Rd St Unit B
Oakland, CA 94607-1806

Mailing address

1438 3Rd St Unit B
Oakland, CA 94607-1806
Phone (415) 606-1752

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
I20150223000629 CA Practitioner - General Surgery 6608191390 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3030 Webster St
Oakland, CA 94609-3411
Phone (510) 250-8000

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1580
Removal of skin lesions284
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A13550CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Skilled Facility Health Care Solutions Inc CurrentSince Jan 7, 2015 Accepting new patients
Skilled Biologics, Inc. CurrentSince Jul 1, 2024 Accepting new patients

Locations

3746 Foothill Blvd
La Crescenta, CA 91214
Phone (323) 574-0387

3747 Foothill Blvd
#B140
La Crescenta, CA 91214
Phone 3104455999255

12021 Wilshire Blvd
Los Angeles, CA 90025
Phone (310) 348-1900

3030 Webster St
Oakland, CA 94609
Phone (510) 250-8000

6401 33rd St
Riverside, CA 92509
Phone (909) 681-2200

2108 N St
Sacramento, CA 95816
Phone (951) 719-7050

1340 15th St
Santa Monica, CA 90404
Phone (310) 451-9700

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432252800000",
    "number": "1629334032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1438 3RD ST UNIT B",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946071806",
            "telephone_number": "415-606-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1438 3RD ST UNIT B",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946071806",
            "telephone_number": "415-606-1752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIMA",
        "first_name": "KRISTIAN",
        "middle_name": "SHINYU",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-10",
        "last_updated": "2015-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "20A13550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.