Individual provider Active NPI

Ikuyo Yamaguchi, MD

  • Pediatric Nephrology Physician
  • Oklahoma City, OK
National Provider Identifier
1700995073
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
P8827 Issued in TX
Practice address
1200 Childrens Ave
Oklahoma City, OK 73104-4637
Phone
(405) 271-4211
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD00041921 WA
Pediatric Nephrology Physician 2080P0210X MD00041921 WA
Pediatric Nephrology Physician 2080P0210X P8827 TX Primary

Addresses

Primary practice location

1200 Childrens Ave
Oklahoma City, OK 73104-4637

Mailing address

1200 Childrens Ave
Oklahoma City, OK 73104-4637
Phone (405) 271-4211

Other practice location 1

4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 358-8309

Other identifiers 1

IdentifierTypeStateIssuer
331948501MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140430001498 TX Practitioner - Pediatric Medicine 2163420886 Reassigns benefits to 2 organizations
I20210625001449 OK Practitioner - NephrologyPractitioner - Pediatric Medicine 2163420886 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Pediatric Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ou Health Partners IncGroup PAC ID 5991105876, 1,167 clinicians

Practice addresses (Care Compare)

1200 Childrens Ave
Oklahoma City, OK 73104-4637
Phone (405) 271-2669

900 NE 10TH St
Ouhp Family Medicine
Oklahoma City, OK 73104-5420
Phone (572) 244-0065

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.26 of 100Reported as group
Quality
53.73
Promoting interoperability
100
Improvement activities
40
Cost
70.48

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00041921WAMDPediatrics Physician
P8827TXMDPediatric Nephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Community Medicine Associates Pediatrics CurrentSince Aug 1, 2016 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Mar 17, 2021 Accepting new patients
University of Texas Health Science Center at San Antonio Pediatrics CurrentSince Mar 17, 2014 Accepting new patients
The University of Texas Health Science Center at San Antonio CurrentSince Mar 17, 2014 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Mar 17, 2021 Accepting new patients
Ou Medicine Inc. Past Accepting new patients

Locations

1200 Childrens Ave
Ste 5D
Oklahoma City, OK 73104
Phone (405) 271-4211

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

1200 Childrens Ave
Oklahoma City, OK 73104
Phone (405) 271-2429

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

903 W Martin St
#492
San Antonio, TX 78207
Phone (210) 358-3441

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

Interoperability endpoints

  • Direct secure messaging: iyamaguchi22903@ouhealth.direct-ci.net

Organizations & group practices 8

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1700995073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CHILDRENS AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731044637",
            "telephone_number": "405-271-4211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CHILDRENS AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731044637",
            "telephone_number": "405-271-4211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4502 Medical Dr",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782294402",
            "country_code": "US",
            "telephone_number": "210-358-8309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAMAGUCHI",
        "first_name": "IKUYO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00041921",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "WA",
            "license": "MD00041921",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "TX",
            "license": "P8827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "331948501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.