Individual provider Active NPI

Spencer Kitchin, MD

  • Cardiovascular Disease Physician
  • Sacramento, CA
National Provider Identifier
1730716135
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
185866 Issued in CA
Practice address
4860 Y St Ste 2820
Sacramento, CA 95817-2307
Phone
(916) 734-8657
NPI assigned
Mar 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 185866 CA
Cardiovascular Disease Physician 207RC0000X 185866 CA Primary

Addresses

Primary practice location

4860 Y St Ste 2820
Sacramento, CA 95817-2307

Mailing address

1000 W Carson St Dept 200
Torrance, CA 90502-2004
Phone (925) 683-4170

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240115000006 CA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 2365894490

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
185866CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Past Accepting new patients

Organizations & group practices 1

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": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1730716135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W CARSON ST DEPT 200",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022004",
            "telephone_number": "925-683-4170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4860 Y ST STE 2820",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172307",
            "telephone_number": "916-734-8657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITCHIN",
        "first_name": "SPENCER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-25",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "185866",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "185866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.