Individual provider Active NPI

Katherine Aloysius Killmond

  • Pediatrics Physician
  • Orange, CA
National Provider Identifier
1053997726
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A193134 Issued in CA
Practice address
505 S Main St Ste 525
Orange, CA 92868-4553
Phone
(714) 456-5631
Fax
(714) 285-0389
NPI assigned
Mar 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X A193134 CA Primary

Addresses

Primary practice location

505 S Main St Ste 525
Orange, CA 92868-4553

Mailing address

505 S Main St Ste 525
Orange, CA 92868-4553
Phone (714) 456-5631

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
I20240618000486 CA Practitioner - Pediatric Medicine 2961878152 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A193134CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California Irvine CurrentSince Jul 1, 2024 Accepting new patients
UC Regents Uci Dept of Pediatrics Pediatrics CurrentSince Jul 1, 2024 Accepting new patients
University of California Irvine CurrentSince Jul 1, 2024 Accepting new patients
University of California Irvine PastSince Mar 28, 2021 Accepting new patients
Children'S Hospital of Orange County Pediatrics PastSince Apr 20, 2025 Accepting new patients
Pediatric Subspecialty Faculty, Inc. Pediatrics Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

2441 W La Palma Ave
Anaheim, CA 92801
Phone (657) 282-6356

300 W Carl Karcher Way
Anaheim, CA 92801
Phone (657) 282-6356

2441 W La Palma Ave
Ste 100
Anaheim, CA 92801
Phone (657) 282-6356

505 S Main St
Ste 525
Orange, CA 92868
Phone (714) 456-5631

200 S Manchester Ave
Ste 300
Orange, CA 92868
Phone (714) 424-9001

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

505 S Main St
Ste 160
Orange, CA 92868
Phone (714) 509-3444

800 N Main St
Santa Ana, CA 92701
Phone (714) 456-6324

Organizations & group practices 7

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": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1053997726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S MAIN ST STE 525",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684553",
            "telephone_number": "714-456-5631",
            "fax_number": "714-285-0389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S MAIN ST STE 525",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684553",
            "telephone_number": "714-456-5631",
            "fax_number": "714-285-0389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLMOND",
        "first_name": "KATHERINE",
        "middle_name": "ALOYSIUS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A193134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.