Individual provider Active NPI

Minami Konishi, NP

  • Nurse Practitioner
  • Anaheim, CA
National Provider Identifier
1982211769
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN-3049 Issued in HI
Practice address
710 N Euclid St Ste 203
Anaheim, CA 92801-4122
Phone
(714) 551-9720
Fax
(714) 560-7678
NPI assigned
Sep 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X APRN-3049 HI
Nurse Practitioner 363L00000X APRN-3049 HI Primary

Addresses

Primary practice location

710 N Euclid St Ste 203
Anaheim, CA 92801-4122

Mailing address

710 N Euclid St Ste 400
Anaheim, CA 92801-4132
Phone (714) 551-9720

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221018002151 CA Practitioner - Nurse Practitioner 3476973892 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Foothill Urgent Care CurrentSince Jan 1, 2023 Accepting new patients
Metropolitan Ipa Current Accepting new patients
Amg, a Professional Medical Corporation CurrentSince Aug 22, 2025 Accepting new patients

Locations

925 S Garfield Ave
Alhambra, CA 91801
Phone (626) 300-8388

710 N Euclid St
Ste 101
Anaheim, CA 92801
Phone (714) 517-2000

710 N Euclid St
Ste 203
Anaheim, CA 92801
Phone (714) 551-9720

710 N Euclid St
Ste 400
Anaheim, CA 92801
Phone (714) 517-2000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1982211769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N EUCLID ST STE 400",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928014132",
            "telephone_number": "714-551-9720",
            "fax_number": "714-560-7678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 N EUCLID ST STE 203",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928014122",
            "telephone_number": "714-551-9720",
            "fax_number": "714-560-7678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONISHI",
        "first_name": "MINAMI",
        "name_prefix": "Miss",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-25",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "HI",
            "license": "APRN-3049",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "HI",
            "license": "APRN-3049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.