KELLY NISHIKAWA
NPI 1679004717
Student in an Organized Health Care Education/Training Program in Oakland, CA

Active since March 21, 2017PECOS EnrolledAccepts Medicare Assignment
275 W MACARTHUR BLVD, OAKLAND, CA 94611(510) 752-1000 Get Directions Write a Review

NPPES record last updated: December 3, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 3, 2021, Mar 21, 2017 (2 updates tracked since 2017).

About Kelly Nishikawa NPPES

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

KELLY NISHIKAWA (NPI 1679004717) is an individual student in an organized health care education/training program in Oakland, California and active in the NPI registry since March 2017. She is enrolled in Medicare PECOS and is a graduate of Loma Linda University School Of Medicine (2017).

NPPES Registry Identity

NPI1679004717
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameKELLY NISHIKAWA
Location Address275 W MACARTHUR BLVDOakland, CA 94611-5641
Mailing Address275 W Macarthur BlvdOakland, CA 94611-5641
Sole ProprietorNo
Medical School CMSLoma Linda University School Of MedicineGraduated 2017
Enumeration DateMarch 21, 2017
Last NPPES UpdateDecember 3, 20212 updates tracked since enumeration
NPI 1679004717 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

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.

275 W MACARTHUR BLVD, Oakland, CA 94611

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

Kelly Nishikawa 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 ID9335488659
PECOS Enrollment IDI20201019002433
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.

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.

Specialist
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Radiology (Radiation Oncology)
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Radiology (Diagnostic Radiology)
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Student in an Organized Health Care Education/Training Program
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Physical Therapist (Orthopedic)
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Student in an Organized Health Care Education/Training Program
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Obstetrics & Gynecology
275 W MACARTHUR BLVD
OAKLAND, CA 94611
Hospitalist
275 W MACARTHUR BLVD
OAKLAND, CA 94611

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 Kelly Nishikawa's NPI number?

The NPI number for Kelly Nishikawa is 1679004717. It was assigned to this individual provider in the NPPES registry on March 21, 2017.

Where is Kelly Nishikawa located?

Kelly Nishikawa practices at 275 W Macarthur Blvd, Oakland, CA 94611. The listed phone number is (510) 752-1000.

What is Kelly Nishikawa's specialty?

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

Is Kelly Nishikawa enrolled in Medicare?

Yes. Kelly Nishikawa 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.

When was this NPI record last updated?

The NPPES record for Kelly Nishikawa was last updated on December 3, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.