Active NPI
Kekoa Christian Ede, MD
- Psychiatry Physician
- Escondido, CA
National Provider Identifier
1134224843
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A101211
- Practice address
- 488 E Valley Pkwy Ste 311
Escondido, CA 92025-3374 - Phone
- (760) 520-8100
- NPI assigned
- Sep 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A101211 | CA | Primary |
| Internal Medicine Physician | 207R00000X | MD-12408 | HI | |
| Internal Medicine Physician | 207R00000X | A101211 | CA | |
| Psychiatry Physician | 2084P0800X | MD-12408 | HI |
Addresses
Primary practice location
488 E Valley Pkwy Ste 311
Escondido, CA 92025-3374
Mailing address
488 E Valley Pkwy Ste 311
Escondido, CA 92025-3374
Phone (760) 520-8100
Other practice location 1
460 N Elm St
Escondido, CA 92025-3002
Phone (760) 520-8100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W14158 | Other | CA | SITE MEDICARE NUMBER |
| ZZZ20041Z | Other | CA | SITE MEDICARE NUMBER |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
460 N Elm St
Escondido, CA 92025-3002
Phone (760) 520-8100
855 E Madison Ave
El Cajon, CA 92020-3819
Phone (619) 440-2751
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101211 | CA | MD | Marriage & Family Therapist |
| A101211 | CA | MD | Internal Medicine Physician |
| MD-12408 | HI | MD | Psychiatry Physician |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- kekoa.ede@nh.eclinicaldirectplus.com
Organizations & group practices 1
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.
-
- Federally Qualified Health Center (FQHC)
- Escondido, CA
- NPI 1598703647
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772755200000",
"number": "1134224843",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "488 E VALLEY PKWY STE 311",
"city": "ESCONDIDO",
"state": "CA",
"postal_code": "920253374",
"telephone_number": "760-520-8100",
"fax_number": "760-737-2039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "488 E VALLEY PKWY STE 311",
"city": "ESCONDIDO",
"state": "CA",
"postal_code": "920253374",
"telephone_number": "760-520-8100"
}
],
"practiceLocations": [
{
"address_1": "460 N Elm St",
"address_purpose": "LOCATION",
"city": "Escondido",
"state": "CA",
"postal_code": "920253002",
"country_code": "US",
"telephone_number": "760-520-8100",
"fax_number": "760-737-2039",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EDE",
"first_name": "KEKOA",
"middle_name": "CHRISTIAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-14",
"last_updated": "2026-03-06",
"certification_date": "2026-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A101211",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "HI",
"license": "MD-12408",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A101211",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "HI",
"license": "MD-12408",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SITE MEDICARE NUMBER",
"identifier": "W14158",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SITE MEDICARE NUMBER",
"identifier": "ZZZ20041Z",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Escondido, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.