KEIKO LILLY MIMURA MSN, APRN, BC
NPI 1932142544
Nurse Practitioner - Gerontology in Los Angeles, CA

Active since June 13, 2006PECOS EnrolledAccepts Medicare Assignment
11500 NIMITZ AVE, LOS ANGELES, CA 90049(424) 832-8368(424) 832-8270 Get Directions Write a Review

NPPES record last updated: May 21, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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

NPI1932142544
Entity TypeIndividualFemale
Primary Taxonomy363LG0600X
Provider Legal NameKEIKO LILLY MIMURACredential: MSN, APRN, BC
Location Address11500 NIMITZ AVELos Angeles, CA 90049-3566
Mailing Address11500 Nimitz AveLos Angeles, CA 90049-3566 · (424) 832-8368 · Fax (424) 832-8270
Fax(424) 832-8270
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateJune 13, 2006
Last NPPES UpdateMay 21, 2013
NPI 1932142544 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License Licensed in CA · 14487
11500 NIMITZ AVE, Los Angeles, CA 90049

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

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.

PECOS PAC ID8729227442
PECOS Enrollment IDI20180810001745
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 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.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
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 18

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

Occupational Therapist
11500 NIMITZ AVE
LOS ANGELES, CA 90049
Social Worker (Clinical)
11500 NIMITZ AVE
LOS ANGELES, CA 90049
Dietitian, Registered
11500 NIMITZ AVE
LOS ANGELES, CA 90049
Psychiatry & Neurology (Geriatric Psychiatry)
11500 NIMITZ AVE
LOS ANGELES, CA 90049
Pharmacist (Pharmacotherapy)
11500 NIMITZ AVE, ATTN: PHARMACY
LOS ANGELES, CA 90049
Surgery
11500 NIMITZ AVE
LOS ANGELES, CA 90049
Occupational Therapist (Physical Rehabilitation)
11500 NIMITZ AVE, REHAB 3 FLOOR
LOS ANGELES, CA 90049
Psychologist (Clinical)
11500 NIMITZ AVE
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.

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.