NPIMap

Individual provider Active NPI

Daniel F Ikemiyashiro, M.D.

  • Nephrology Physician
  • Merced, CA
National Provider Identifier
1801837208
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A54201 Issued in CA
Practice address
1140 Olivewood Dr
Merced, CA 95348-1210
Phone
(209) 725-2121
Fax
(209) 725-2123
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A54201 CA Primary

Addresses

Primary practice location

1140 Olivewood Dr
Merced, CA 95348-1210

Mailing address

1140 Olivewood Dr
Merced, CA 95348-1210
Phone (209) 725-2121

Other identifiers 1

IdentifierTypeStateIssuer
GR0082110MedicaidCA

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
I20080717000418 CA Practitioner - NephrologyPractitioner - Internal Medicine 1254404627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Nephrology Group IncGroup PAC ID 4688767262, 50 clinicians

Practice addresses (Care Compare)

1140 Olivewood Dr
Merced, CA 95348-1210
Phone (559) 228-6600

Hospital & facility affiliations

  • SHC Merced Dialysis facility, Merced, CA, CCN 552653
  • DaVita Los Banos Dialysis Dialysis facility, Los Banos, CA, CCN 052738
  • SHC Central Merced Dialysis facility, Merced, CA, CCN 752537
  • DaVita Pacheco Dialysis Dialysis facility, Los Banos, CA, CCN 552804
  • DaVita Atwater Dialysis Dialysis facility, Atwater, CA, CCN 052706
  • Mercy Medical Center Hospital, Merced, CA, CCN 050444
  • Memorial Hospital Los Banos Hospital, Los Banos, CA, CCN 050528
  • John C Fremont Healthcare District Hospital, Mariposa, CA, CCN 051304

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54201CAMDPharmacist
A54201CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Nephrology Group, Inc. Clinical Lab CurrentSince Jun 1, 2021 Accepting new patients
The Nephrology Group, Inc. Nephrology Current Accepting new patients
Memorail Hospital of Los Banos Past Accepting new patients
Golden Valley Health Center Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

568 E Herndon Ave
Ste 201
Fresno, CA 93720
Phone (559) 228-9660

1451 W Pacheco Blvd
Ste E
Los Banos, CA 93635
Phone (209) 725-2121

801 W L St
Los Banos, CA 93635
Phone (209) 710-6333

1140 Olivewood Dr
Merced, CA 95348
Phone (209) 725-2121

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: dikemiyashiro@cvnma-ca.direct.office.nextgen.com

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1801837208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 OLIVEWOOD DR",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953481210",
            "telephone_number": "209-725-2121",
            "fax_number": "209-725-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 OLIVEWOOD DR",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953481210",
            "telephone_number": "209-725-2121",
            "fax_number": "209-725-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKEMIYASHIRO",
        "first_name": "DANIEL",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A54201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0082110",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

Verify at the official NPI Registry.