Individual provider Active NPI

Kevin Jae Choi, M.D.

  • Otolaryngology Physician
  • Los Angeles, CA
National Provider Identifier
1134486681
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A156572 Issued in CA
Practice address
966 S Western Ave Ste 101
Los Angeles, CA 90006-1014
Phone
(213) 267-2566
Fax
(213) 463-9131
NPI assigned
Apr 20, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngic Allergy Physician 207YX0602X A156572 CA
Pediatric Otolaryngology Physician 207YP0228X A156572 CA
Otolaryngology Physician 207Y00000X A156572 CA Primary

Addresses

Primary practice location

966 S Western Ave Ste 101
Los Angeles, CA 90006-1014

Mailing address

966 S Western Ave Ste 101
Los Angeles, CA 90006-1014
Phone (213) 267-2566

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
I20191216000539 CA Practitioner - Otolaryngology 8527339720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Eastern Virginia Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kevin Jae Choi MD Ms a Professional Medical CorporationGroup PAC ID 5395179741, 3 clinicians

Practice addresses (Care Compare)

966 S Western Ave
Los Angeles, CA 90006-1014
Phone (213) 267-2256

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A156572CAMDOtolaryngic Allergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
JKPC, LLC Otolaryngology Current Accepting new patients
Kevin Jae Choi, MD, Ms a Professional Medical Corporation Otolaryngology CurrentSince Sep 27, 2019 Accepting new patients
Geoffrey Trenkle DO a Professional Medical Corporation Otolaryngology PastSince Aug 1, 2021 Accepting new patients
Samir a Shah MD Professional Corporation Past Accepting new patients

Locations

5832 Beach Blvd
Unit 206
Buena Park, CA 90621
Phone (714) 752-6835

903 Crenshaw Blvd
Ste 105
Los Angeles, CA 90019
Phone (323) 240-2900

966 S Western Ave
Ste 101
Los Angeles, CA 90006
Phone (213) 267-2256

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kevin.choi@244638591549444.direct.elationemr.com

Organizations & group practices 4

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 2

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": "1334880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1134486681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "966 S WESTERN AVE STE 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900061014",
            "telephone_number": "213-267-2566",
            "fax_number": "213-463-9131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "966 S WESTERN AVE STE 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900061014",
            "telephone_number": "213-267-2566",
            "fax_number": "213-463-9131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "KEVIN",
        "middle_name": "JAE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-20",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "CA",
            "license": "A156572",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "CA",
            "license": "A156572",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A156572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.