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KENT TADOKORO
NPI 1285096602
Student in an Organized Health Care Education/Training Program in Maywood, IL

Active since March 24, 2016PECOS EnrolledAccepts Medicare Assignment
2160 S 1ST AVE, MAYWOOD, IL 60153(708) 216-1676 Get Directions Write a Review

NPPES record last updated: September 26, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jan 26, 2023, Mar 24, 2016 (2 updates tracked since 2016).

About Kent Tadokoro NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENT TADOKORO (NPI 1285096602) is an individual student in an organized health care education/training program in Maywood, Illinois and active in the NPI registry since March 2016. He is enrolled in Medicare PECOS and is a graduate of Medical College Of Wisconsin (2016).

NPPES Registry Identity

NPI1285096602
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameKENT TADOKORO
Location Address2160 S 1ST AVEMaywood, IL 60153-3328
Mailing Address2160 S 1st AveMaywood, IL 60153-3328
Phone(708) 216-1676
Sole ProprietorYes
Medical School CMSMedical College Of WisconsinGraduated 2016
Enumeration DateMarch 24, 2016
Last NPPES UpdateSeptember 26, 20232 updates tracked since enumeration
NPPES CertifiedJanuary 26, 2023
✔ NPI 1285096602 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2160 S 1ST AVE, Maywood, IL 60153
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kent Tadokoro is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6901197516
PECOS Enrollment IDI20221012002024
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kent Tadokoro reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group
1,678 mi
Health Maintenance Organization
3527 W FLORIDA AVE
Hemet, CA 92545
  • Reassigned Medicare billing, California enrollment
  • Also billed through NPI 1982863783 (California)
  • 5,228 clinicians in this Medicare group
NPI 1013433465 (877) 608-0044

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANITA OZA NAGAMINE M.D.
Radiology (Diagnostic Radiology)
2160 S 1ST AVE
MAYWOOD, IL 60153
Cook County (708) 216-9000
DR. BRYCE ANDREW PASCHOLD D.P.M.
Podiatrist (Foot & Ankle Surgery)
2160 S 1ST AVE
MAYWOOD, IL 60153
Cook County (708) 216-4254
DR. ANTONIO HERNANDO IGLESIAS M.D.
Psychiatry & Neurology (Neurology)
2160 S 1ST AVE
MAYWOOD, IL 60153
Cook County (708) 216-9000
IAN CHARLES MCCOMB
Oral & Maxillofacial Surgery
2160 S 1ST AVE
MAYWOOD, IL 60153
Cook County (708) 216-9000
JAMES WU D.O.
Psychiatry & Neurology (Psychiatry)
2160 S 1ST AVE
MAYWOOD, IL 60153
Cook County (708) 216-9000
PAIGE T SONG MD
Student in an Organized Health Care Education/Training Program
2160 S 1ST AVE
MAYWOOD, IL 60153
Cook County (888) 584-7888
ELIZABETH CHO
Orthopaedic Surgery
2160 S 1ST AVE
MAYWOOD, IL 60153
Cook County (708) 216-1274
DR. CATHRYN T SAWALSKI DO, MBA
Internal Medicine
2160 S 1ST AVE
MAYWOOD, IL 60153
Cook County (888) 584-7888

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kent Tadokoro's NPI number?

The NPI number for Kent Tadokoro is 1285096602. It was assigned to this individual provider in the NPPES registry on March 24, 2016.

Where is Kent Tadokoro located?

Kent Tadokoro practices at 2160 S 1st Ave, Maywood, IL 60153. The listed phone number is (708) 216-1676.

What is Kent Tadokoro's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Kent Tadokoro enrolled in Medicare?

Yes. Kent Tadokoro is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Kent Tadokoro's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kent Tadokoro reassigns Medicare benefits to Southern California Permanente Medical Group (Hemet, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kent Tadokoro's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kent Tadokoro was last updated on September 26, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.