NPIMap

Individual provider Active NPI

Thomas Christopher Kockinis, MD

  • Family Medicine Physician
  • Huntington Beach, CA
National Provider Identifier
1952312712
Registry record updated Aug 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A40769 Issued in CA
Practice address
18811 Huntington Street
Suite 130
Huntington Beach, CA 92648-6003
Phone
(714) 596-1105
Fax
(714) 596-1155
NPI assigned
Aug 10, 2006
Last updated
Aug 9, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A40769 CA Primary
Interventional Pain Medicine Physician 208VP0014X 5084 CA

Addresses

Primary practice location

18811 Huntington Street
Suite 130
Huntington Beach, CA 92648-6003

Mailing address

18811 Huntington Street
Suite 130
Huntington Beach, CA 92648-6003
Phone (714) 596-1105

Other identifiers 1

IdentifierTypeStateIssuer
00A407691OtherMEDICAL

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
I20081015000002 CA Practitioner - Family PracticePractitioner - Interventional Pain Management 7214972231 Practice locations: Huntington Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Interventional Pain Management
Education
State University of New York at Buffalo School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18811 Huntington St
Huntington Beach, CA 92648-6003
Phone (714) 596-1105

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5084CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of California Irvine Interventional Pain Medicine Past Accepting new patients
Pih Health Downey Hospital Interventional Pain Medicine Past Accepting new patients
Long Beach Memorial Medical Interventional Pain Medicine Past Accepting new patients
Long Beach Memorial Medical Interventional Pain Medicine Past Accepting new patients
Orange Coast Memorial Medical Center Interventional Pain Medicine Past Accepting new patients
Los Alamitos Medical Center, Inc. Interventional Pain Medicine Past Accepting new patients
St. Mary Medical Center Interventional Pain Medicine Past Accepting new patients
Orange County Global Medical Center, Inc Interventional Pain Medicine Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312848000000",
    "number": "1952312712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18811 HUNTINGTON STREET",
            "address_2": "SUITE 130",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926486003",
            "telephone_number": "714-596-1105",
            "fax_number": "714-596-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18811 HUNTINGTON STREET",
            "address_2": "SUITE 130",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926486003",
            "telephone_number": "714-596-1105",
            "fax_number": "714-596-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCKINIS",
        "first_name": "THOMAS",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2011-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A40769",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "5084",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "00A407691",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.