Kenji Irie, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A30886 Issued in CA

Practice address

420 E Third St
Suite 903
Los Angeles, CA 90013

Phone

(213) 617-0266

Fax

(213) 617-7332

NPI assigned

Sep 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• K I Medical Group

  • Pediatrics Physician
  • Los Angeles, CA
  • NPI 1275641466
  NPD (past) Authorized official

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689778128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E THIRD ST",
            "address_2": "SUITE 903",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90013",
            "telephone_number": "213-617-0266",
            "fax_number": "213-617-7332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E THIRD ST",
            "address_2": "SUITE 903",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90013",
            "telephone_number": "213-617-0266",
            "fax_number": "213-617-7332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRIE",
        "first_name": "KENJI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A30886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Irfan Baker DMD Inc
• David Antonio Irias, APRN
• Maryem Irias, MFTA
• Ana Carolina Iribarren, MD
• Nathalie Iribe
• Clifford Ifeanyi Iriele, M.D.
• Irina a Urusova MD Inc
• Irina Rayfeld DDS Professional Dental Corporation
• Irina Sumenko, D.D.S., Inc.
• Iris Therapy Center, a Psychological Corporation

• General Practice Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.