Koji Kainuma

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

201905019NP-PP Issued in OR

Practice address

255 Lancaster Dr NE
Salem, OR 97301-5155

Phone

(503) 576-8400

Fax

(503) 364-0775

NPI assigned

Mar 7, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA, OR2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Yakima Valley Farm Workers Clinic 274 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkainuma34150@yvfwc.direct-ci.com

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.

• Yakima Valley Farm Workers Clinic

  • Federally Qualified Health Center (FQHC)
  • Hermiston, OR
  • NPI 1427001940

  OR

  Medicare reassignment NPD
• County of Monterey

  • Adult Mental Health Clinic/Center
  • Salinas, CA
  • NPI 1467584805

  CA

  Medicare reassignment
• Yakima Valley Farm Workers Clinic

  • Federally Qualified Health Center (FQHC)
  • Astoria, OR
  • NPI 1316484165
  NPD
• Yakima Valley Farm Workers Clinic

  • Federally Qualified Health Center (FQHC)
  • Clatskanie, OR
  • NPI 1578000345
  NPD

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

{
    "created_epoch": "1394150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1669898268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 LANCASTER DR NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973015155",
            "telephone_number": "503-576-8400",
            "fax_number": "503-364-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 LANCASTER DR NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973015155",
            "telephone_number": "503-576-8400",
            "fax_number": "503-364-0775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 Lancaster Dr NE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973015155",
            "country_code": "US",
            "telephone_number": "503-576-8400",
            "fax_number": "503-364-0775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAINUMA",
        "first_name": "KOJI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-07",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95001713",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201904695RN",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201905019NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkainuma34150@yvfwc.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "YVFWC Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "255 Lancaster Dr NE",
            "city": "Salem",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973015155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Thomas A Kahan, MD
• Damiana Kahn, MS, CCC-SLP
• Laura Alden Kahn, MD/MPH
• Charisma Kahut
• Andres Raul Kaindl, DDS, DMD
• Kaiser Foundation Health Plan of the Northwest
• Kaiser Foundation Health Plan of the Northwest
• Kaiser Foundation Health Plan of the Northwest
• Kaiser Foundation Health Plan of the Northwest
• Kaiser Foundation Health Plan of the Northwest

• All providers in Salem, OR
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.