Individual provider Active NPI

Reebu Kohli, M.D.

  • Nephrology Physician
  • Sylmar, CA
National Provider Identifier
1003068321
Registry record updated Oct 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A101494 Issued in CA
Practice address
14445 Olive View Drive
Sylmar, CA 91342
Phone
(818) 364-3205
NPI assigned
Oct 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A101494 CA Primary

Addresses

Primary practice location

14445 Olive View Drive
Sylmar, CA 91342

Mailing address

14445 Olive View Drive
Sylmar, CA 91342
Phone (818) 364-3205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101210000817 CA Practitioner - Internal Medicine 6507053907 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of San MateoGroup PAC ID 9032023171, 316 clinicians

Practice addresses (Care Compare)

22 W 39TH Ave
Hos316Ms
San Mateo, CA 94403-4364

222 W 39TH Ave
San Mateo, CA 94403-4364

306 Spruce Ave
South San Francisco, CA 94080-2741
Phone (650) 573-2222

Hospital & facility affiliations

  • San Mateo Medical Center Hospital, San Mateo, CA, CCN 050113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A101494CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alameda Health System CurrentSince Feb 8, 2011 Accepting new patients
County of San Mateo CurrentSince May 1, 2012 Accepting new patients
East Bay Nephrology Medical Group, Inc. Nephrology CurrentSince Oct 1, 2010 Accepting new patients
County of San Mateo CurrentSince May 1, 2012 Accepting new patients
Alameda Health System CurrentSince Feb 8, 2011 Accepting new patients
East Bay Nephrology Medical Group, Inc. Nephrology CurrentSince Oct 1, 2010 Accepting new patients

Locations

2905 Telegraph Ave
Berkeley, CA 94705
Phone (510) 841-0411

3043 Summit St
Oakland, CA 94609
Phone (510) 451-6840

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

14020 San Pablo Ave
Ste A
San Pablo, CA 94806
Phone (510) 235-1057

125 Hospital Dr
Vallejo, CA 94589
Phone (707) 642-7510

Interoperability endpoints

  • Direct secure messaging: rkohli19788@smch.direct-ci.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224201600000",
    "number": "1003068321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DRIVE",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "91342",
            "telephone_number": "818-364-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DRIVE",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "91342",
            "telephone_number": "818-364-3205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHLI",
        "first_name": "REEBU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-17",
        "last_updated": "2008-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A101494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylmar, CA

Sources for this page

Verify at the official NPI Registry.