NPIMap

Organization Active NPI

Kenneth C. Low MD a Professional Corporation

  • Ophthalmology Physician
  • Fremont, CA
National Provider Identifier
1952331035
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
KENNETH C. LOW MD A PROFESSIONAL CORPORATION
Practice address
38707 Stivers St
#B
Fremont, CA 94536-5337
Phone
(510) 794-0660
Fax
(510) 793-5044
NPI assigned
Jul 4, 2006
Last updated
May 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Authorized official

Name
Ms. Vanessa Parra
Title
Office Manager
Phone
(510) 794-0660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

38707 Stivers St
#B
Fremont, CA 94536-5337

Mailing address

38707 Stivers St
#B
Fremont, CA 94536-5337
Phone (510) 794-0660

Other identifiers 1

IdentifierTypeStateIssuer
GR0046700MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050307000187 CA Part B Supplier - Clinic/Group Practice 4082668645 Receives reassigned benefits from 7 practitioners
Practice locations: Fremont, CA

National Provider Directory

National Provider Directory

Locations

38707 Stivers St
Fremont, CA 94536
Phone (510) 794-0660

Interoperability endpoints

  • Direct secure messaging: jt@fecp.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651708800000",
    "number": "1952331035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38707 STIVERS ST",
            "address_2": "#B",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945365337",
            "telephone_number": "510-794-0660",
            "fax_number": "510-793-5044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38707 STIVERS ST",
            "address_2": "#B",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945365337",
            "telephone_number": "510-794-0660",
            "fax_number": "510-793-5044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH C. LOW MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A",
        "authorized_official_last_name": "PARRA",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "510-794-0660",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0046700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.