Kevin Takao Kodama, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

G78832 Issued in CA

Practice address

1187 E Herndon Ave Ste 101
Fresno, CA 93720-3166

Phone

(559) 440-0450

Fax

(559) 440-0461

NPI assigned

Jul 27, 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

Other identifiers 4

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

Specialty

Gastroenterology

Education

University of California, San Francisco School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Community Foundation Medical GroupGroup PAC ID 0345406294, 282 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Regional Medical Center Hospital, Fresno, CA, CCN 050060
• Clovis Community Medical Center Hospital, Clovis, CA, CCN 050492
• Saint Agnes Medical Center Hospital, Fresno, CA, CCN 050093
• Kaweah Health Medical Center Hospital, Visalia, CA, CCN 050057

Merit-based Incentive Payment System (MIPS)

Final score

90.41 of 100Reported as group

Quality

87.02

Promoting interoperability

100

Improvement activities

40

Cost

78.21

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Community Foundation Medical Group

  • Internal Medicine Physician
  • Fresno, CA
  • NPI 1811258510
  Medicare reassignment Care Compare group NPD
• Community Foundation Medical Group

  • Orthopaedic Surgery Physician
  • Fresno, CA
  • NPI 1134668353
  NPD
• Community Foundation Medical Group

  • Orthopaedic Surgery Physician
  • Fresno, CA
  • NPI 1376056721
  NPD
• Fresno Community Hospital and Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1104906569
  NPD (past)
• Saint Agnes Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1205845567
  NPD (past)
• Digestive Disease Consultants

  • Gastroenterology Physician
  • Jacksonville, FL
  • NPI 1710251921
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fresno Community Hospital and Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1104906569
  Care Compare affiliation
• Fresno Community Hospital and Medical Center

  • General Acute Care Hospital
  • Clovis, CA
  • NPI 1316027709
  Care Compare affiliation
• Kaweah Delta Health Care District

  • General Acute Care Hospital
  • Visalia, CA
  • NPI 1588663769
  Care Compare affiliation
• Saint Agnes Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1205845567
  Care Compare affiliation

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235433600000",
    "number": "1750395828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1187 E HERNDON AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203166",
            "telephone_number": "559-440-0450",
            "fax_number": "559-440-0461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1187 E HERNDON AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203166",
            "telephone_number": "559-440-0450",
            "fax_number": "559-440-0461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODAMA",
        "first_name": "KEVIN",
        "middle_name": "TAKAO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2009-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G78832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "100014017",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G788320",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G788320",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00G788320",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yvonna Kochergen
• Harry H Kochounian, R.D.O.
• Stefani Koda, LCSW
• Nikitha Kodali, MD
• Clayton Tatsuo Kodama, DDS
• Kathalene Kae Kodman
• Carmen Martell Koenig, NP
• Mohammad Kofahi
• Richard Koff, M.D.
• Koinonia Foster Homes Inc

• Gastroenterology Physician in Fresno, CA
• Providers in Fresno, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2009; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.