Individual provider Active NPI

Kyoko Suzuki, FNP

  • Family Nurse Practitioner
  • Lancaster, CA
National Provider Identifier
1679089056
Registry record updated Dec 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95007872 Issued in CA
Practice address
43322 Gingham Ave
Lancaster, CA 93535-4569
Phone
(661) 874-4050
NPI assigned
Dec 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95007872 CA Primary

Addresses

Primary practice location

43322 Gingham Ave
Lancaster, CA 93535-4569

Mailing address

43322 Gingham Ave
Lancaster, CA 93535-4569
Phone (661) 874-4050

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210722001134 CA Practitioner - Nurse Practitioner 3678976040 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95007872CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Mateo CurrentSince Apr 10, 2021 Accepting new patients
County of San Mateo CurrentSince Apr 10, 2021 Accepting new patients
County of San Mateo CurrentSince Apr 10, 2021 Accepting new patients

Locations

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

Interoperability endpoints

  • Direct secure messaging: ksuzuki252976@direct.ochin.org
  • Direct secure messaging: ksuzuki21390@smch.direct-ci.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": "1513728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513728000000",
    "number": "1679089056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43322 GINGHAM AVE",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935354569",
            "telephone_number": "661-874-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43322 GINGHAM AVE",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935354569",
            "telephone_number": "661-874-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUZUKI",
        "first_name": "KYOKO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-20",
        "last_updated": "2017-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95007872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.