Kenny Tokuji Michioka, is a medicare enrolled "Nurse Practitioner - Family" in Greenfield, California. His current practice location is
467 El Camino Real, Greenfield, California. You can reach out to his office (for appointments etc.) via phone at
(831) 674-0112.
Kenny Tokuji Michioka is licensed to practice in California (license number 95007921) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1215559638.
Provider's Profile
| Full Name | Kenny Tokuji Michioka |
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| Gender | Male |
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| Speciality | Nurse Practitioner - Family |
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| Location | 467 El Camino Real, Greenfield, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1215559638
- Provider Enumeration Date: 05/07/2020
- Last Update Date: 11/16/2023
Medicare PECOS Information:
- PECOS PAC ID: 9638599798
- Enrollment ID: I20201012002601
Medical Identifiers
Medical identifiers for Kenny Tokuji Michioka such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1215559638 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 95007921 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kenny Tokuji Michioka allows following entities to bill medicare on his behalf.
| Entity Name | Southern Monterey County Memorial Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1114917564
PECOS PAC ID: 7719883461
Enrollment ID: O20050216000803 |
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| Entity Name | Bay Area Community Health |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1184791998
PECOS PAC ID: 1658349824
Enrollment ID: O20050330001237 |
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| Entity Name | Wound Masters Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1376063461
PECOS PAC ID: 8224307053
Enrollment ID: O20170710002429 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kenny Tokuji Michioka is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Kenny Tokuji Michioka,
467 El Camino Real,
Greenfield, CA 93927-4915
Ph: () - | Kenny Tokuji Michioka,
467 El Camino Real,
Greenfield, CA 93927-4915
Ph: (831) 674-0112 |
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