Individual provider Active NPI

Ketan M Patel, MD

  • Plastic Surgery Physician
  • Tarzana, CA
National Provider Identifier
1033344817
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
A132442 Issued in CA
Practice address
5411 Etiwanda Ave Ste 200
Tarzana, CA 91356-3648
Phone
(310) 423-2129
Fax
(310) 423-4145
NPI assigned
May 21, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X MD040884 DC
Plastic Surgery Physician 208200000X A132442 CA Primary

Addresses

Primary practice location

5411 Etiwanda Ave Ste 200
Tarzana, CA 91356-3648

Mailing address

4140 W 190TH St
Torrance, CA 90504-5513

Other practice location 1

1450 San Pablo St Ste 6200
Los Angeles, CA 90033-5331
Phone (323) 442-7920

Other practice location 2

18133 Ventura Blvd Ste 300
Tarzana, CA 91356-3645
Phone (310) 423-2129

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ketan.patel@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

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
I20141022002477 CA Practitioner - Plastic and Reconstructive Surgery 8022239763 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Indiana University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians
Cedars-Sinai Medical CenterGroup PAC ID 0446169114, 788 clinicians

Practice addresses (Care Compare)

5411 Etiwanda Ave
Suite 200
Tarzana, CA 91356-3648
Phone (424) 314-0125

8700 Beverly Blvd
West Hollywood, CA 90048-1804
Phone (310) 423-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy45
Melanoma (skin cancer) excision13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A132442CAMDPlastic Surgery Physician
MD040884DCMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Sep 13, 2014 Accepting new patients
Cedars-Sinai Medical Care Foundation CurrentSince Sep 12, 2022 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Sep 12, 2022 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Sep 12, 2022 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Sep 13, 2014 Accepting new patients
Tarzana Medical Center LLC Past Accepting new patients

Locations

1808 Verdugo Blvd
Ste 209
Glendale, CA 91208
Phone (818) 949-4494

1751 Foothill Blvd
Ste 2
La Canada, CA 91011
Phone (323) 442-9700

1450 San Pablo St
Ste 6200
Los Angeles, CA 90033
Phone (323) 442-7920

1500 San Pablo St
Los Angeles, CA 90033
Phone (323) 443-8500

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1510 San Pablo St
Ste 514
Los Angeles, CA 90033
Phone (323) 442-5910

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

1510 San Pablo St
Ste 415
Los Angeles, CA 90033
Phone (323) 442-5843

1516 San Pablo St
Los Angeles, CA 90033
Phone (323) 276-3705

100 W California Blvd
Pasadena, CA 91105
Phone (626) 397-3445

18321 Clark St
Tarzana, CA 91356
Phone (310) 423-6744

5411 Etiwanda Ave
Ste 200
Tarzana, CA 91356
Phone (310) 423-2129

18133 Ventura Blvd
Ste 300
Tarzana, CA 91356
Phone (310) 423-8888

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kpatel431244@direct.cshs.org

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 4

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": "1242864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1033344817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 W 190TH ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5411 ETIWANDA AVE STE 200",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563648",
            "telephone_number": "310-423-2129",
            "fax_number": "310-423-4145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1450 San Pablo St Ste 6200",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900335331",
            "country_code": "US",
            "telephone_number": "323-442-7920",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18133 Ventura Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Tarzana",
            "state": "CA",
            "postal_code": "913563645",
            "country_code": "US",
            "telephone_number": "310-423-2129",
            "fax_number": "310-423-4145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KETAN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-21",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "DC",
            "license": "MD040884",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A132442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ketan.patel@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1450 San Pablo St Ste 6200",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900335331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

Verify at the official NPI Registry.