Individual provider Active NPI

Kiumars Saketkhoo, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Whittier, CA
National Provider Identifier
1093782518
Registry record updated Jun 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
A32779 Issued in CA
Practice address
12462 E Putnam St
Ste 208
Whittier, CA 90602-1005
Phone
(562) 789-5470
Fax
(562) 789-4480
NPI assigned
Mar 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X A32779 CA Primary
Pulmonary Disease Physician 207RP1001X A32779 CA

Addresses

Primary practice location

12462 E Putnam St
Ste 208
Whittier, CA 90602-1005

Mailing address

PO Box 511225
Los Angeles, CA 90051-3023
Phone (562) 789-5470

Other identifiers 1

IdentifierTypeStateIssuer
GR0084320MedicaidCA

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
I20041230000788 CA Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 8224091145 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Whittier Pulmonary and Critical Care Medical Group, Inc.Group PAC ID 8022192376, 15 clinicians

Practice addresses (Care Compare)

12462 Putnam St
Suite 208
Whittier, CA 90602-1049
Phone (562) 789-5470

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32779CAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Whittier Pulmonary and Critical Care Medical Group, Inc. Pulmonary Disease CurrentSince Jun 1, 2007 Accepting new patients
Starling Oncology FL, LLC Past Accepting new patients
Daniel Akvavan,MD Inc Critical Care Medicine Past Accepting new patients
Pih Health Whittier Hospital Past Accepting new patients
Kiumars Saketkhoo MD, Inc Critical Care Medicine Past Accepting new patients
Intercommunity Family Medical Asoociates, Inc. Past Accepting new patients

Locations

12401 Washington Blvd
Whittier, CA 90602
Phone (562) 698-0611

12462 Putnam St
Ste 208
Whittier, CA 90602
Phone (562) 789-5470

Interoperability endpoints

  • Direct secure messaging: kiumarssaketkhoo@pihh.allscriptsdirect.net

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 1

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": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277164800000",
    "number": "1093782518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 511225",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900513023",
            "telephone_number": "562-789-5470",
            "fax_number": "562-789-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12462 E PUTNAM ST",
            "address_2": "STE 208",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906021005",
            "telephone_number": "562-789-5470",
            "fax_number": "562-789-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAKETKHOO",
        "first_name": "KIUMARS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2010-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "A32779",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A32779",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0084320",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

Verify at the official NPI Registry.