Individual provider Active NPI

Jack Shih-Chieh Kao, M.D.

  • Anesthesiology Physician
  • Los Angeles, CA
National Provider Identifier
1013960475
Registry record updated Mar 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A69438 Issued in CA
Practice address
1155 S Grand Ave Apt 1212
Los Angeles, CA 90015-2789
Phone
(714) 309-6697
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 219901 MA
Internal Medicine Physician 207R00000X A69438 CA
Anesthesiology Physician 207L00000X A69438 CA Primary

Addresses

Primary practice location

1155 S Grand Ave Apt 1212
Los Angeles, CA 90015-2789

Mailing address

1155 S Grand Ave Apt 1212
Los Angeles, CA 90015-2789
Phone (714) 309-6697

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
I20070131000606 CA Practitioner - Anesthesiology 2769487693 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Tufts University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Quality Care Anesthesia Consultants IncGroup PAC ID 3779706874, 21 clinicians

Practice addresses (Care Compare)

5700 San Fernando Rd
Glendale, CA 91202-2104
Phone (818) 688-0886

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A69438CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bayside Anesthesia Medical Group CurrentSince Feb 1, 2015 Accepting new patients
La Quality Care Anesthesia Consultants Inc Anesthesiology CurrentSince Oct 27, 2016 Accepting new patients
Pacific Valley Medical Group Anesthesiology CurrentSince Jan 21, 2015 Accepting new patients
Century Anesthesia Assoc. Anesthesiology PastSince Aug 1, 2005 Accepting new patients

Locations

716 W Broadway
#200
Glendale, CA 91204
Phone (818) 696-0091

1500 E Chevy Chase Dr
Ste 101
Glendale, CA 91206
Phone (818) 265-1581

5700 San Fernando Rd
Glendale, CA 91202
Phone (818) 637-7766

11645 Wilshire Blvd
Ste 987
Los Angeles, CA 90025
Phone (310) 289-8600

333 S Arroyo Pkwy
Fl 3
Pasadena, CA 91105
Phone (626) 440-9161

1328 22nd St
Santa Monica, CA 90404
Phone (310) 829-5511

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425254400000",
    "number": "1013960475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 S GRAND AVE APT 1212",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900152789",
            "telephone_number": "714-309-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 S GRAND AVE APT 1212",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900152789",
            "telephone_number": "714-309-6697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAO",
        "first_name": "JACK",
        "middle_name": "SHIH-CHIEH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2015-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "219901",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A69438",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A69438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.