Individual provider Active NPI

Kenneth Shinji Kishihara, O.T.

  • Hand Occupational Therapist
  • Fresno, CA
National Provider Identifier
1679771638
Registry record updated Oct 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
OT3030 Issued in CA
Practice address
7120 N Whitney Ave
Suite 102
Fresno, CA 93720-0153
Phone
(559) 323-4831
Fax
(559) 323-4815
NPI assigned
Jul 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X OT3030 CA Primary

Addresses

Primary practice location

7120 N Whitney Ave
Suite 102
Fresno, CA 93720-0153

Mailing address

47900 Willow Pond Rd
Coarsegold, CA 93614-8720
Phone (559) 683-5460

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121119000140 CA Practitioner - Occupational Therapist in Private Practice 4385895143 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1630 E Herndon Ave
Fresno, CA 93720-3391
Phone (559) 290-7051

2335 E Kashian LN
Fresno, CA 93701-2234

Merit-based Incentive Payment System (MIPS)

Final score
90.41 of 100Reported as group
Quality
87.02
Promoting interoperability
100
Improvement activities
40
Cost
78.21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT3030CAMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Foundation Medical Group Current Accepting new patients
Sierra Pacific Orthopaedic Center Medical Group Inc CurrentSince Jul 19, 2019 Accepting new patients
Community Foundation Medical Group CurrentSince Apr 1, 2021 Accepting new patients
Sierra Pacific Orthopaedic Center Medical Group, Inc. CurrentSince Jul 19, 2019 Accepting new patients
Community Foundation Medical Group CurrentSince Apr 1, 2021 Accepting new patients

Locations

1630 E Herndon Ave
Fresno, CA 93720
Phone (559) 256-5200

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

Interoperability endpoints

  • Direct secure messaging: kenneth.kishihara.p1@direct.spocortho.nextgenshare.com

Organizations & group practices 6

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": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349308800000",
    "number": "1679771638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47900 WILLOW POND RD",
            "city": "COARSEGOLD",
            "state": "CA",
            "postal_code": "936148720",
            "telephone_number": "559-683-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7120 N WHITNEY AVE",
            "address_2": "SUITE 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937200153",
            "telephone_number": "559-323-4831",
            "fax_number": "559-323-4815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISHIHARA",
        "first_name": "KENNETH",
        "middle_name": "SHINJI",
        "name_prefix": "Mr.",
        "credential": "O.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2012-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "CA",
            "license": "OT3030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2012; 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.