David Aloysius Ketelaar, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

G77236 Issued in CA

Practice address

1400 E Church St
Santa Maria, CA 93454-5906

Phone

(805) 739-3200

Fax

(805) 739-3064

NPI assigned

Jul 3, 2006

Last updated

Sep 9, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • Santa Ana, CA
  • NPI 1548667843
  Medicare reassignment NPD
• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • San Luis Obispo, CA
  • NPI 1295781615
  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283990400000",
    "number": "1073543542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 W MEMORIAL ROAD",
            "address_2": "SUITE 121",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731341722",
            "telephone_number": "405-751-4664",
            "fax_number": "405-751-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E CHURCH ST",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545906",
            "telephone_number": "805-739-3200",
            "fax_number": "805-739-3064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETELAAR",
        "first_name": "DAVID",
        "middle_name": "ALOYSIUS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2010-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G77236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G772360",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacquelyn Lee Kemp, DPT
• Anne Kristen Kennard, DOA
• Kathleen April Kennedy, M.D.
• Virgilia Elizabeth Kennedy, LCSW
• Michelle Evonne Ketchum
• Lailani Ketz
• Brigette Ann Keys
• Truc Kha
• Siri Atma Singh Khalsa, MD
• Husain Khambati

• Emergency Medicine Physician in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.