KEIKO LILLY MIMURA MSN, APRN, BC
NPI 1932142544
Nurse Practitioner - Gerontology in Los Angeles, CA
About Keiko Lilly Mimura Msn, Aprn, Bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KEIKO LILLY MIMURA MSN, APRN, BC (NPI 1932142544) is an individual gerontology provider in Los Angeles, California, licensed in California (14487) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS and is a graduate of Other (2003).
NPPES Registry Identity
Specialties & Licenses
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
Keiko Lilly Mimura Msn, Aprn, Bc 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.
Medicare Billing Reassignments
2Medicare enrollment records show Keiko Mimura reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Los Angeles, CA 90034
- Reassigned Medicare billing, California enrollment
- Medicare enrollment name: Minghsun Liu MD PC
- 95 clinicians in this Medicare group
Beverly Hills, CA 90211
- Reassigned Medicare billing, California enrollment
- 9 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 90049 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 17
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LOS ANGELES, CA 90049
LOS ANGELES, CA 90049
LOS ANGELES, CA 90049
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 Keiko Mimura's NPI number?
The NPI number for Keiko Mimura is 1932142544. It was assigned to this individual provider in the NPPES registry on June 13, 2006.
Where is Keiko Mimura located?
Keiko Mimura practices at 11500 Nimitz Ave, Los Angeles, CA 90049. The listed phone number is (424) 832-8368.
What is Keiko Mimura's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.
Is Keiko Mimura enrolled in Medicare?
Yes. Keiko Mimura 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 organizations bill Medicare for Keiko Mimura's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Keiko Mimura reassigns Medicare benefits to 2 organizations: Minghsun Liu, M.D., PC (Los Angeles, CA) and Temima Healthcare (Beverly Hills, CA). Each 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 Keiko Mimura'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 Keiko Mimura was last updated on May 21, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Keiko Lilly Mimura, MSN, APRN, BC · NPI 1932142544
Gerontology physician in Los Angeles, California. Individual provider, active in the CMS NPPES registry since June 13, 2006.
## Identity
- **NPI:** 1932142544 (Entity type: Individual)
- **Enumerated:** June 13, 2006
- **Primary specialty:** Nurse Practitioner - Gerontology · taxonomy 363LG0600X
- **State license:** 14487 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 11500 NIMITZ AVE, Los Angeles, CA 90049-3566
- **Phone:** (424) 832-8368 · **Fax:** (424) 832-8270
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Minghsun Liu, M.D., PC (NPI 1518309368, Los Angeles, CA); Temima Healthcare (NPI 1245078054, Beverly Hills, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2003
## Record status
- **NPPES last updated:** May 21, 2013
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Source: [NPI Profile](https://npiprofile.com/npi/1932142544) · Data from the CMS NPPES public registry.