Individual provider Active NPI

Kartik Kansagra

  • Vascular & Interventional Radiology Physician
  • Glendale, CA
National Provider Identifier
1043604465
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
A143946 Issued in CA
Practice address
1509 Wilson Ter
Glendale, CA 91206-4007
Phone
(818) 409-8000
NPI assigned
Mar 24, 2015
Last updated
Dec 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0204X A143946 CA Primary

Addresses

Primary practice location

1509 Wilson Ter
Glendale, CA 91206-4007

Mailing address

28049 Smyth Dr
Valencia, CA 91355-4023
Phone (818) 906-6900

Other practice location 1

4733 W Sunset Blvd Fl 3
Los Angeles, CA 90027-6021
Phone (323) 783-4516

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20170123001292 CA Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 3274821202 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
Tulane University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MD Solutions Medical CorpGroup PAC ID 1759379993, 11 clinicians
Evsla Medical CorporationGroup PAC ID 2567824501, 3 clinicians
Simi Valley Hospital and Health Care ServicesGroup PAC ID 3173423399, 23 clinicians

Practice addresses (Care Compare)

1500 E Chevy Chase Dr
Suite 201
Glendale, CA 91206-4199
Phone (818) 863-4099

1509 Wilson Ter
Glendale, CA 91206-4007
Phone (818) 409-8000

15477 Ventura Blvd
Suite 100
Sherman Oaks, CA 91403-3046
Phone (818) 906-2141

28049 Smyth Dr
Valencia, CA 91355-4023
Phone (818) 906-6900

2975 Sycamore Dr
Simi Valley, CA 93065-1201
Phone (805) 955-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.77 of 100Reported as group
Quality
78.77
Promoting interoperability
92
Improvement activities
40
Cost
48

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal16
Leg revascularization (restoring blood flow)21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A143946CAMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Dec 14, 2016 Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 18, 2021 Accepting new patients
Southern California Permanente Medical Group Single Specialty Current Accepting new patients
Glendale Adventist Medical Center CurrentSince Sep 1, 2024 Accepting new patients
Evsla Medical Corporation Single Specialty CurrentSince Jun 1, 2024 Accepting new patients
Southern California Permanente Medical Group Single Specialty Current Accepting new patients
Glendale Adventist Medical Center Single Specialty CurrentSince Sep 1, 2024 Accepting new patients
MD Solutions Medical Corp Single Specialty CurrentSince Feb 1, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 14, 2016 Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3184

18501 Gale Ave
Ste 150
City of Industry, CA 91748
Phone (626) 854-2020

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

1500 E Chevy Chase Dr
Ste 201
Glendale, CA 91206
Phone (818) 863-4099

1509 Wilson Ter
Glendale, CA 91206
Phone (818) 409-8071

1530 E Chevy Chase Dr
Ste 107
Glendale, CA 91206
Phone (661) 705-9706

25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111

1127 Wilshire Blvd
Ste 1000
Los Angeles, CA 90017
Phone (213) 328-3600

3616 E 1st St
Los Angeles, CA 90063
Phone (213) 264-6157

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

4733 W Sunset Blvd
Fl 3
Los Angeles, CA 90027
Phone (323) 783-1431

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

1064 N Ventura Rd
Oxnard, CA 93030

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

15477 Ventura Blvd
Ste 100
Sherman Oaks, CA 91403
Phone (818) 906-2141

2950 Sycamore Dr
Ste 200
Simi Valley, CA 93065
Phone (661) 705-9706

28049 Smyth Dr
Valencia, CA 91355
Phone (661) 705-9706

888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 11

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

Hospital & facility affiliations 6

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": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1043604465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28049 SMYTH DR",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913554023",
            "telephone_number": "818-906-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 WILSON TER",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064007",
            "telephone_number": "818-409-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4733 W Sunset Blvd Fl 3",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900276021",
            "country_code": "US",
            "telephone_number": "323-783-4516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANSAGRA",
        "first_name": "KARTIK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-24",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "A143946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4733 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.