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SHINOBU LUISA KANEKO M.D. INC
NPI 1609047893
Family Medicine in Monterey Park, CA

Active since March 17, 2008
823 S ATLANTIC BLVD STE 4, MONTEREY PARK, CA 91754(626) 458-1201(626) 458-3736 Get Directions Write a Review

NPPES record last updated: October 17, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Shinobu Luisa Kaneko M.d. Inc NPPES

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

SHINOBU LUISA KANEKO M.D. INC (NPI 1609047893) is a healthcare organization registered as a family medicine in Monterey Park, California and active in the NPI registry since March 2008. The organization lists Shinobu Luisa Kaneko, Owner, as its authorized official.

NPPES Registry Identity

NPI1609047893
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSHINOBU LUISA KANEKO M.D. INC
Location Address823 S ATLANTIC BLVD STE 4Monterey Park, CA 91754-4721
Mailing AddressPo Box 129Monterey Park, CA 91754-0129 · (626) 458-1201 · Fax (626) 458-3736
Phone(626) 458-1201
Fax(626) 458-3736
Organization SubpartNo
Authorized OfficialShinobu Luisa KanekoOwner · (323) 728-1201
Enumeration DateMarch 17, 2008
Last NPPES UpdateOctober 17, 2022
NPPES CertifiedOctober 17, 2022
✔ NPI 1609047893 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · A80720
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
823 S ATLANTIC BLVD STE 4, Monterey Park, CA 91754
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Other Identifiers 1

Medicaid00A807200CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shinobu Luisa Kaneko M.d. Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by February 28, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateCaliforniaEnrollment IDO20050201000607Non-DME Part B · Clinic/Group PracticeDue dateFebruary 28, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Shinobu Luisa Kaneko M.D. Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Shinobu Kaneko, M.D.
Family Practice
NPI 1750388633
823 S ATLANTIC BLVD STE 4
Monterey Park, CA 91754
(626) 458-1201
✔ PECOSSame address

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

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 Shinobu Luisa Kaneko M.D. Inc's NPI number?

The NPI number for Shinobu Luisa Kaneko M.D. Inc is 1609047893. It was assigned to this organization in the NPPES registry on March 17, 2008.

Where is Shinobu Luisa Kaneko M.D. Inc located?

Shinobu Luisa Kaneko M.D. Inc is located at 823 S Atlantic Blvd Ste 4, Monterey Park, CA 91754. The listed phone number is (626) 458-1201.

What is Shinobu Luisa Kaneko M.D. Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Shinobu Luisa Kaneko M.D. Inc enrolled in Medicare?

Yes. Shinobu Luisa Kaneko M.D. Inc is registered in the Medicare PECOS enrollment system.

When is Shinobu Luisa Kaneko M.D. Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Shinobu Luisa Kaneko M.D. Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Shinobu Luisa Kaneko M.D. Inc. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Shinobu Luisa Kaneko M.D. Inc was last updated on October 17, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.