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MIA MATSUDA KANAK MD, MPH
NPI 1508251687
Pediatrics in New York, NY

Active since April 05, 2015PECOS Enrolled
525 E 68TH ST # 179, NEW YORK, NY 10065(866) 463-2778 Get Directions Write a Review

NPPES record last updated: September 30, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 13, 2020, Dec 19, 2017, Mar 18, 2017 (3 updates tracked since 2017).

About Mia Matsuda Kanak Md, Mph NPPES

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

MIA MATSUDA KANAK MD, MPH (NPI 1508251687) is an individual pediatrics provider in New York, New York, licensed in California (A154810) and active in the NPI registry since April 2015. She is enrolled in Medicare PECOS and is a graduate of Stanford University School Of Medicine (2015).

NPPES Registry Identity

NPI1508251687
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameMIA MATSUDA KANAKCredential: MD, MPH
Location Address525 E 68TH ST # 179New York, NY 10065-4870
Mailing Address525 E 68th St # 179New York, NY 10065-4870 · (866) 463-2778
Phone(866) 463-2778
Sole ProprietorNo
Medical School CMSStanford University School Of MedicineGraduated 2015
Enumeration DateApril 5, 2015
Last NPPES UpdateSeptember 30, 20253 updates tracked since enumeration
NPPES CertifiedSeptember 30, 2025
✔ NPI 1508251687 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A154810
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
525 E 68TH ST # 179, New York, NY 10065
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mia Matsuda Kanak Md, Mph is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9234551557
PECOS Enrollment IDI20251008004444
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10065 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
$102.04 typical visit price
range $65.69 – $198.19
Typical copayment $25.51 (range $16.42 – $49.54)
Most-billed visit code 99203
Established Patient
$114.88 typical visit price
range $21.20 – $160.66
Typical copayment $28.72 (range $5.30 – $40.16)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

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

ISABELLA JOELLE RYDER
Nurse Practitioner (Acute Care)
525 E 68TH ST # 179
NEW YORK, NY 10065
New York County (212) 746-5454
HAMZA IJAZ MD
Emergency Medicine
525 E 68TH ST # 179
NEW YORK, NY 10065
New York County (703) 340-7700
JACQUELYN VICTORY DEJESUS
Physician Assistant
525 E 68TH ST # 179
NEW YORK, NY 10065
New York County (212) 746-5454
SARAH ELLEN PERELMAN MD
Emergency Medicine
525 E 68TH ST # 179
NEW YORK, NY 10065
New York County (215) 510-9708
JUSTINE SARAH KO M.D.
Emergency Medicine (Sports Medicine)
525 E 68TH ST # 179
NEW YORK, NY 10065
New York County (212) 746-0282
CAITLIN O'ROURKE
Physician Assistant
525 E 68TH ST # 179
NEW YORK, NY 10065
New York County (212) 746-5026
CHRISTOPHER JOSEPH CLOHESSY MSN
Nurse Practitioner (Acute Care)
525 E 68TH ST # 179
NEW YORK, NY 10065
New York County (247) 244-1784
TRISHA MAE MAGPANTAY MSN, RN, AGACNP-BC
Nurse Practitioner (Acute Care)
525 E 68TH ST # 179
NEW YORK, NY 10065
New York County (212) 746-5454

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 Mia Kanak's NPI number?

The NPI number for Mia Kanak is 1508251687. It was assigned to this individual provider in the NPPES registry on April 5, 2015.

Where is Mia Kanak located?

Mia Kanak practices at 525 E 68th St # 179, New York, NY 10065. The listed phone number is (866) 463-2778.

What is Mia Kanak's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Mia Kanak enrolled in Medicare?

Yes. Mia Kanak is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mia Kanak was last updated on September 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.