Individual provider Active NPI

Bernice Pui Sim Kahkosko, FNP-BC

  • Family Nurse Practitioner
  • Apple Valley, CA
National Provider Identifier
1730816877
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NPF95021151 Issued in CA
Practice address
18300 US Highway 18
Apple Valley, CA 92307-2206
Phone
(760) 242-2311
NPI assigned
Aug 8, 2022
Last updated
Aug 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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 NPF95021151 CA Primary

Addresses

Primary practice location

18300 US Highway 18
Apple Valley, CA 92307-2206

Mailing address

18300 US Highway 18
Apple Valley, CA 92307-2206
Phone (760) 242-2311

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
I20221228002985 CA Practitioner - Nurse Practitioner 4082084454 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Desert Valley Medical Group IncGroup PAC ID 4880595875, 78 clinicians

Practice addresses (Care Compare)

16850 Bear Valley Rd
Victorville, CA 92395-5794
Phone (760) 241-8000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NPF95021151CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Navdeep Loomba MD Inc. CurrentSince Oct 1, 2024 Accepting new patients
Desert Valley Medical Group, Inc. Current Accepting new patients
Desert Valley Medical Group, Inc. CurrentSince Sep 15, 2022 Accepting new patients
Desert Valley Medical Group, Inc CurrentSince Sep 15, 2022 Accepting new patients
Desert Valley Medical Group, Inc. Past Accepting new patients
Desert Valley Medical Group, Inc. Past Accepting new patients
Desert Valley Medical Group, Inc. Past Accepting new patients
Desert Valley Hospital, LLC Past Accepting new patients
Desert Valley Medical Group, Inc. Past Accepting new patients

Locations

12276 Hesperia Rd
Ste 2
Victorville, CA 92395

15610 Bear Valley Rd
Victorville, CA 92395
Phone (760) 245-9999

15610 Bear Valley Rd
Ste A
Victorville, CA 92395
Phone (760) 245-9999

16850 Bear Valley Rd
Victorville, CA 92395
Phone (760) 241-8222

16850 Bear Valley Rd
Ste 102
Victorville, CA 92395

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: bernice.kahkosko.p1@direct.dvmg.nextgenshare.com

Organizations & group practices 9

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": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1730816877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18300 US HIGHWAY 18",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072206",
            "telephone_number": "760-242-2311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18300 US HIGHWAY 18",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072206",
            "telephone_number": "760-242-2311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAHKOSKO",
        "first_name": "BERNICE",
        "middle_name": "PUI SIM",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NPF95021151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, CA

Sources for this page

Verify at the official NPI Registry.