NPIMap

Individual provider Active NPI

Tim Ruksa Kuson, M.D.

  • Otolaryngology Physician
  • Sherman Oaks, CA
National Provider Identifier
1891724753
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A40625 Issued in CA
Practice address
4910 Van Nuys Blvd
Suite 201
Sherman Oaks, CA 91403-1879
Phone
(626) 419-6842
Fax
(323) 550-1530
NPI assigned
Jul 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A40625 CA Primary

Addresses

Primary practice location

4910 Van Nuys Blvd
Suite 201
Sherman Oaks, CA 91403-1879

Mailing address

4910 Van Nuys Blvd
Suite 201
Sherman Oaks, CA 91403-1879
Phone (626) 419-6842

Other names 1

  • Dr. Termsak Kusonruksa Former name

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
I20050420001173 CA Practitioner - OtolaryngologyPractitioner - Endocrinology 5698713535 Practice locations: South Pasadena, CA

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1345 Indiana Ave
South Pasadena, CA 91030-3624
Phone (626) 419-6842

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Community Care Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Providence Facey Medical Foundation Past Accepting new patients
Mahfouz M. Michael,M.D.,Inc. Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Henry Mayo Newhall Memorial Hospital Past Accepting new patients
San Dimas Community Hospital, Inc. Past Accepting new patients
Emanate Health Foothill Presbyterian Hospital Past Accepting new patients
Mahfouz M. Michael,M.D.,Inc. Past Accepting new patients
Pih Health Whittier Hospital Past Accepting new patients

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1891724753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 VAN NUYS BLVD",
            "address_2": "SUITE 201",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031879",
            "telephone_number": "626-419-6842",
            "fax_number": "323-550-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 VAN NUYS BLVD",
            "address_2": "SUITE 201",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031879",
            "telephone_number": "626-419-6842",
            "fax_number": "323-550-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSON",
        "first_name": "TIM",
        "middle_name": "RUKSA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A40625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERMSAK",
            "last_name": "KUSONRUKSA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.