Individual provider Active NPI

Thomas Henry Kanegae, M.D.

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1902805914
Registry record updated Dec 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G25710 Issued in CA
Practice address
1245 Wilshire Blvd
Ste 804
Los Angeles, CA 90017-4810
Phone
(213) 977-1030
Fax
(213) 977-0379
NPI assigned
Jul 20, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G25710 CA Primary

Addresses

Primary practice location

1245 Wilshire Blvd
Ste 804
Los Angeles, CA 90017-4810

Mailing address

1245 Wilshire Blvd
#804
Los Angeles, CA 90017-4810
Phone (213) 977-1030

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110407000150 CA Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 6800070384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1245 Wilshire Blvd
Suite 616
Los Angeles, CA 90017-4806

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G25710CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas H Kanegae M D a Medical Corporation Internal Medicine CurrentSince Oct 2, 2010 Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients
Thomas H. Kanegae M.D. AMC PastSince Nov 10, 1981 Accepting new patients

Locations

1245 Wilshire Blvd
Ste 804
Los Angeles, CA 90017
Phone (213) 482-2992

1245 Wilshire Blvd
Ste 616
Los Angeles, CA 90017
Phone (213) 977-1225

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hollenbeck PalmsLos Angeles, CA, CCN 055115 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Dec 2, 2009
Dec 2, 2009

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323302400000",
    "number": "1902805914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BLVD",
            "address_2": "#804",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174810",
            "telephone_number": "213-977-1030",
            "fax_number": "213-977-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BLVD",
            "address_2": "STE 804",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174810",
            "telephone_number": "213-977-1030",
            "fax_number": "213-977-0379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANEGAE",
        "first_name": "THOMAS",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2011-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G25710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.