DR. KEN YAMAGUCHI MD
NPI 1376561001
Orthopaedic Surgery in Chicago, IL

Q: What is Ken Yamaguchi's NPI number?

The NPI number for Ken Yamaguchi is 1376561001. It was assigned to this individual provider in the NPPES registry on July 18, 2006.

Q: What is Ken Yamaguchi's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for Ken Yamaguchi was last updated on August 4, 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.

Active since July 18, 2006PECOS EnrolledAccepts Medicare Assignment

94.1/100

CMS Quality Rating

259 E ERIE ST FL 13, CHICAGO, IL 60611(312) 695-6800(312) 926-6600 Get Directions Write a Review

NPPES record last updated: August 4, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 12, 2021, Nov 14, 2016, Oct 2, 2015 (3 updates tracked since 2015).

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About Dr. Ken Yamaguchi Md NPPES

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

DR. KEN YAMAGUCHI MD (NPI 1376561001) is an individual orthopaedic surgery provider in Chicago, Illinois, licensed in Illinois (036164044) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Northwestern Memorial Hospital, and maintains a secondary practice location in Saint Louis.

NPPES Registry Identity

NPI1376561001

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameDR. KEN YAMAGUCHICredential: MD

Location Address259 E ERIE ST FL 13Chicago, IL 60611-3926

Mailing Address259 E Erie St Fl 13Chicago, IL 60611-3926 · (312) 695-6800 · Fax (312) 926-6600

Phone(312) 695-6800

Fax(312) 926-6600

Sole ProprietorNo

Medical School CMSGeorge Washington University School Of MedicineGraduated 1989

Enumeration DateJuly 18, 2006

Last NPPES UpdateAugust 4, 20233 updates tracked since enumeration

NPPES CertifiedAugust 4, 2023

✔ NPI 1376561001 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

Licenses✔ Licensed in IL · 036164044✔ Licensed in MO · 108927

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

259 E ERIE ST FL 13, Chicago, IL 60611

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Secondary Practice Location 1

Location 11 Barnes Jewish Hospital Plz, Div Ortho Surg Adult Reconstructive SurgSaint Louis, MO 63110-1003 · Phone (314) 747-2551 · Fax (314) 747-2598

Other Identifiers 1

Medicaid208031807MO

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Ken Yamaguchi Md 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 ID4284779190

PECOS Enrollment IDI20230515000281

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.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

95 services57 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

49 services40 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

40 services40 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

13 services13 patients

Prosthetic repair of shoulder joint, total shoulder 23472

Total shoulder prosthetic repair is a surgical procedure to replace a damaged shoulder joint with artificial components. It aims to relieve pain and restore mobility. The procedure involves replacing the ball (humeral head) and socket (glenoid) of the shoulder joint.

12 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northwestern Memorial Hospital

Acute Care Hospitals · Chicago, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140281

Location251 E Huron StChicago, IL 60611 · Cook County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60611 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.06 typical visit price

range $60.08 – $183.39

Typical copayment $23.51 (range $15.02 – $45.84)

Most-billed visit code 99203

Established Patient

$74.80 typical visit price

range $18.97 – $148.12

Typical copayment $18.70 (range $4.74 – $37.03)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

94.1/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

82.59

Promoting Interoperability

100

Improvement Activities

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.

JEREMY LARVA PA-C

Physician Assistant