NPIMap

Individual provider Active NPI

Thomas I Kanomata, MD

  • Internal Medicine Physician
  • Grass Valley, CA
National Provider Identifier
1659336543
Registry record updated Sep 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
66689 Issued in GA
Practice address
280 Sierra College Dr
Suite 120
Grass Valley, CA 95945-5763
Phone
(530) 477-4480
Fax
(530) 274-7532
NPI assigned
Apr 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 66689 GA Primary

Addresses

Primary practice location

280 Sierra College Dr
Suite 120
Grass Valley, CA 95945-5763

Mailing address

3400 Data Dr
Physician Support Services - 2ND FL
Rancho Cordova, CA 95670-7956

Other identifiers 1

IdentifierTypeStateIssuer
003116311AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141013002051 CA Practitioner - Internal Medicine 2264441419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Loma Linda University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

280 Sierra College Dr
Suite 120
Grass Valley, CA 95945-5763
Phone (530) 477-4420

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation CurrentSince Aug 4, 2014 Accepting new patients
Dignity Health Medical Foundation Current Accepting new patients
Dignity Health Medical Foundation CurrentSince Aug 4, 2014 Accepting new patients
North Georgia Eye Care LLC Past Accepting new patients
Kettering Medical Center Past Accepting new patients
Adventist Health System Georgia Inc PastSince Jan 1, 2003 Accepting new patients
Sierra Nevada Memorial-Miners Hospital Past Accepting new patients
Kettering Medical Center Past Accepting new patients

Locations

280 Sierra College Dr
Ste 120
Grass Valley, CA 95945
Phone (530) 477-4420

280 Sierra College Dr
Ste 105
Grass Valley, CA 95945
Phone (530) 273-3400

3400 Data Dr
Fl 2
Rancho Cordova, CA 95670

3400 Data Dr
Fl 1
Rancho Cordova, CA 95670
Phone (916) 379-2726

401 E Highland Ave
Ste 251
Sn Bernrdno, CA 92404
Phone (909) 881-1614

Organizations & group practices 8

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410825600000",
    "number": "1659336543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "address_2": "PHYSICIAN SUPPORT SERVICES - 2ND FL",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 SIERRA COLLEGE DR",
            "address_2": "SUITE 120",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455763",
            "telephone_number": "530-477-4480",
            "fax_number": "530-274-7532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANOMATA",
        "first_name": "THOMAS",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2014-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "66689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003116311A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

Verify at the official NPI Registry.