Kwame Boateng Agyeman
Individual provider Active NPI Internal Medicine Physician · Loma Linda, CA
NPI 1821521527 · NPPES record last updated Jul 6, 2021
Key facts
- NPI
- 1821521527
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- A158219 (CA)
- Practice address
- 25590 Prospect Ave
43E
Loma Linda, CA 92354-3141 - Phone
- (951) 640-9517
- NPI assigned
- Apr 10, 2017
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 21
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Loma Linda University School of Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sac Health System
American Current Care of California a Medical Corporation
Practice addresses (Care Compare)
1454 E 2ND St
San Bernardino, CA 92408-0118
Phone (909) 382-7100
250 S G St
San Bernardino, CA 92410-3320
Phone (909) 382-7100
599 Inland Ctr Dr
Suite 105
San Bernardino, CA 92408-1819
Phone (909) 889-2665
Hospital & facility affiliations
- Flower Home Health, Inc
- Tender Home Health
- Loma Linda University Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210617002970 | CA | Practitioner - Internal Medicine | 9931509569 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A158219 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Unifam Home Healthcare, Inc | Current | Accepting new patients | |
| Sac Health System | Current |
Accepting new patients | |
| American Current Care of California, a Medical Corporation | Current |
Accepting new patients | |
| Sac Health System | Current |
Accepting new patients | |
| Medhome Healthcare Inc. | Current | Accepting new patients | |
| American Current Care of California, a Medical Corporation | Current |
Accepting new patients | |
| American Current Care of California, a Medical Corporation | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| A-Life Medical Transport, Inc | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current |
Accepting new patients | |
| Sac Health System | Current | Accepting new patients |
Locations (25 of 26)
1800 Westwind Dr
Ste 301
Bakersfield, CA 93301
Phone (661) 327-9617
81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830
2555 S East Ave
Fresno, CA 93706
Phone (559) 499-2400
82934 Civic Center Dr
Indio, CA 92201
Phone (760) 477-0733
11234 Anderson St
#A600
Loma Linda, CA 92350
Phone (909) 558-2824
25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617
File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300
1340 Mitchell Rd
Modesto, CA 95351
Phone (209) 581-9711
25115 Madison Ave
Murrieta, CA 92562
Phone (951) 600-9070
1101 S Milliken Ave
Ste C
Ontario, CA 91761
Phone (909) 390-2799
1851 Lombard St
Ste 100
Oxnard, CA 93030
Phone (805) 983-2234
640 S Placentia Ave
Placentia, CA 92870
Phone (714) 579-7772
9405 Fairway View Pl
Rancho Cucamonga, CA 91730
Phone (909) 481-7345
599 Inland Center Dr
Ste 105
San Bernardino, CA 92408
Phone (909) 889-2665
250 S G St
San Bernardino, CA 92410
Phone (909) 771-2990
2 Connecticut St
San Francisco, CA 94107
Phone (415) 621-5055
2587 Merced St
San Leandro, CA 94577
Phone (510) 351-3553
740 Nordahl Rd
Ste 131
San Marcos, CA 92069
Phone (760) 432-9000
988 Walsh Ave
Santa Clara, CA 95050
Phone (408) 988-6868
1221 N Dutton Ave
Santa Rosa, CA 95401
Phone (707) 543-8360
1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146
1374 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (840) 444-7745
3 S Linden Ave
South San Francisco, CA 94080
Phone (650) 238-1500
3663 Arch Rd
Ste 400
Stockton, CA 95215
Phone (209) 943-2202
21081 S Western Ave
Ste 150
Torrance, CA 90501
Phone (310) 782-3333
Interoperability endpoints
- kagyeman61727@direct.llu.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A158219 | CA | Yes |
Addresses
Primary practice location
25590 Prospect Ave
43E
Loma Linda, CA 92354-3141
Mailing address
25590 Prospect Ave
43E
Loma Linda, CA 92354-3141
Phone (951) 640-9517
Other providers in Loma Linda, CA
- Latimer Aguilar
- Samantha Aguilar
- Mildred Greys Aguirre
- Marius Jordan Bautista Agustin
- James Agustines
- Borhaan Ahmad
- Imdad - Ahmad
- Maleeha Ahmad
- Mazna Tamkin Ahmad
- Shabana Ahmad
All providers in Loma Linda, CA · Internal Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 6, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.