NPIMap

Individual provider Active NPI

Naoko Ikeda, DO

  • Family Medicine Physician
  • Antioch, CA
National Provider Identifier
1952403909
Registry record updated Jun 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
002697 Issued in NY
Practice address
3903 Lone Tree Way
104
Antioch, CA 94509-6249
Phone
(925) 755-1255
Fax
(925) 755-1259
NPI assigned
Sep 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 002697 NY Primary

Addresses

Primary practice location

3903 Lone Tree Way
104
Antioch, CA 94509-6249

Mailing address

3903 Lone Tree Way
104
Antioch, CA 94509-6249
Phone (925) 755-1255

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
I20080108000566 CA Practitioner - Family Practice 9436150133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Healthcare AllianceGroup PAC ID 6305748799, 334 clinicians

Practice addresses (Care Compare)

2160 Appian Way
Suite 200
Pinole, CA 94564-2565
Phone (510) 724-9110

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Healthcare Alliance CurrentSince Jan 6, 2014 Accepting new patients
Affinity Medical Group Past Accepting new patients
Enloe Medical Center Past Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
Sutter Delta Medical Center Past Accepting new patients
Elder Medical Services PC PastSince Aug 1, 2004 Accepting new patients

Locations

50 E Hamilton Ave
Ste 280
Campbell, CA 95008
Phone (408) 227-2646

1300 Crane St
Menlo Park, CA 94025
Phone (510) 785-5000

2160 Appian Way
Ste 200
Pinole, CA 94564
Phone (510) 724-9110

4725 1st St
Ste 100
Pleasanton, CA 94566
Phone (925) 462-7060

100A San Pablo Towne Ctr
San Pablo, CA 94806
Phone (510) 237-2802

Interoperability endpoints

  • Direct secure messaging: nikeda84112@direct.stanfordhealthcare.org

Organizations & group practices 6

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.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276214400000",
    "number": "1952403909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 LONE TREE WAY",
            "address_2": "104",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945096249",
            "telephone_number": "925-755-1255",
            "fax_number": "925-755-1259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 LONE TREE WAY",
            "address_2": "104",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945096249",
            "telephone_number": "925-755-1255",
            "fax_number": "925-755-1259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKEDA",
        "first_name": "NAOKO",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2010-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "002697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

Verify at the official NPI Registry.