Individual provider Active NPI

Keiko Kanzaki, N.P.

  • Family Nurse Practitioner
  • Culver City, CA
National Provider Identifier
1699119636
Registry record updated Jun 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22821 Issued in CA
Practice address
10850 Stever St
Culver City, CA 90230-5464
Phone
(310) 714-9821
Fax
(310) 837-0684
NPI assigned
Apr 22, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2013

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 22821 CA Primary

Addresses

Primary practice location

10850 Stever St
Culver City, CA 90230-5464

Mailing address

10850 Stever St
Culver City, CA 90230-5464
Phone (310) 714-9821

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
I20131227001179 CA Practitioner - Nurse Practitioner 1153558853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11500 Nimitz Ave
Los Angeles, CA 90049-3566
Phone (424) 832-8200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Veterans Affairs of the State of California CurrentSince Mar 26, 2020 Accepting new patients
Department of Veterans Affairs of the State of California Current Accepting new patients

Locations

11500 Nimitz Ave
Los Angeles, CA 90049
Phone (424) 832-8200

1227 O St
Rm 402
Sacramento, CA 95814

Organizations & group practices 2

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 1

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": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370908800000",
    "number": "1699119636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10850 STEVER ST",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902305464",
            "telephone_number": "310-714-9821",
            "fax_number": "310-837-0684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10850 STEVER ST",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902305464",
            "telephone_number": "310-714-9821",
            "fax_number": "310-837-0684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANZAKI",
        "first_name": "KEIKO",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-22",
        "last_updated": "2013-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "22821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

Verify at the official NPI Registry.