Individual provider Active NPI

Kevin Porciuncula, M.D.

  • Family Medicine Physician
  • Union City, CA
National Provider Identifier
1629456520
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A156667 Issued in CA
Practice address
33077 Alvarado Niles Rd
Union City, CA 94587-3109
Phone
(510) 248-1500
Fax
(510) 675-0846
NPI assigned
May 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MT208466 PA
Family Medicine Physician 207Q00000X A156667 CA Primary

Addresses

Primary practice location

33077 Alvarado Niles Rd
Union City, CA 94587-3109

Mailing address

2500 Mowry Ave Ste 255
Fremont, CA 94538-1605

Other practice location 1

5215 Centre Ave
Pittsburgh, PA 15232-1303
Phone (412) 623-2287

Other practice location 2

5215 Centre Ave
Pittsburgh, PA 15232-1303
Phone (412) 623-2287

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181205003422 CA Practitioner - Family Practice 7416262597 Reassigns benefits to 1 organization
Practice locations: Hayward, CA

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.74 of 100Reported as group
Quality
66.48
Promoting interoperability
100
Improvement activities
40
Cost
75.97

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A156667CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Township Medical Foundation Family Medicine CurrentSince Mar 1, 2021 Accepting new patients
Washington Township Medical Foundation CurrentSince Mar 1, 2021 Accepting new patients
Hill Physicians Care Solutions, Inc. PastSince Jun 30, 2019 Accepting new patients

Locations

2500 Mowry Ave
Ste 255
Fremont, CA 94538

39500 Fremont Blvd
Ste 100
Fremont, CA 94538
Phone (510) 248-1800

33077 Alvarado Niles Rd
Union City, CA 94587
Phone (510) 248-1500

Interoperability endpoints

  • Direct secure messaging: kporciuncula126731@direct.whhs.com
  • Direct secure messaging: kevin.porciunculamdl.p1@direct.jwch.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1629456520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 MOWRY AVE STE 255",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33077 ALVARADO NILES RD",
            "city": "UNION CITY",
            "state": "CA",
            "postal_code": "945873109",
            "telephone_number": "510-248-1500",
            "fax_number": "510-675-0846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5215 Centre Ave",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152321303",
            "country_code": "US",
            "telephone_number": "412-623-2287",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5215 Centre Ave",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152321303",
            "country_code": "US",
            "telephone_number": "412-623-2287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORCIUNCULA",
        "first_name": "KEVIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-12",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT208466",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A156667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; 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.