NPIMap

Individual provider Active NPI

Elias Nicolas Kiwan, M.D.

  • Hematology & Oncology Physician
  • Sacramento, CA
National Provider Identifier
1790875276
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
C54469 Issued in CA
Practice address
1020 29TH Street
Suite 680
Sacramento, CA 95816-5124
Phone
(916) 453-3300
Fax
(916) 453-3313
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E-3479 AR
Hospitalist Physician 208M00000X E-3479 AR
Hematology & Oncology Physician 207RH0003X C54469 CA Primary

Addresses

Primary practice location

1020 29TH Street
Suite 680
Sacramento, CA 95816-5124

Mailing address

10470 Old Placerville Rd
Suite 100
Sacramento, CA 95827-2539
Phone (800) 470-0071

Other identifiers 1

IdentifierTypeStateIssuer
150033001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110803000932 CA Practitioner - Hematology/OncologyPractitioner - Hematology 5294904470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Hematology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

1020 29TH St
Sacramento, CA 95816-5125

2241 Douglas Blvd
Suite 110And100
Roseville, CA 95661-4260
Phone (916) 783-8900

2800 L St
Sacramento, CA 95816-5616

2825 Capitol Ave
Sacramento, CA 95816-6039
Phone (916) 454-6600

3161 L St
Sacramento, CA 95816-5234
Phone (916) 453-9999

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-3479ARMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Internal Medicine Current Accepting new patients
Sutter Valley Medical Foundation Internal Medicine CurrentSince Jul 18, 2011 Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients

Locations

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

Interoperability endpoints

  • Direct secure messaging: ekiwan84368@hisp.ehr.sutterhealth.org

Organizations & group practices 5

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 7

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1790875276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 29TH STREET",
            "address_2": "SUITE 680",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165124",
            "telephone_number": "916-453-3300",
            "fax_number": "916-453-3313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIWAN",
        "first_name": "ELIAS",
        "middle_name": "NICOLAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-3479",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AR",
            "license": "E-3479",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "C54469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150033001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.