Elliot Kolin, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

G060634 Issued in CA

Practice address

10842 Portofino PL
Los Angeles, CA 90077-2301

Phone

(310) 440-0294

NPI assigned

Nov 7, 2015

Last updated

Oct 27, 2021By 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

Electronic endpoints 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

Specialty

Diagnostic RadiologyAlso: Interventional Radiology

Education

Icahn School of Medicine at Mount Sinai, 1986

Medicare assignment

May accept Medicare assignment

Group practices

Radiology Medical Group of WMMCGroup PAC ID 0244247864, 29 clinicians

Southern California Permanente Medical GroupGroup PAC ID 6002729175, shared by 4 NPIs, 11,250 clinicians

Ukiah Adventist HospitalGroup PAC ID 6406816123, 136 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health White Memorial Hospital, Los Angeles, CA, CCN 050103

Merit-based Incentive Payment System (MIPS)

Final score

90.74 of 100Reported as group

Quality

94

Promoting interoperability

92

Improvement activities

40

Cost

65.12

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.

• Radiology Medical Group of WMMC

  • Diagnostic Radiology Physician
  • Los Angeles, CA
  • NPI 1831123868
  Medicare reassignment Care Compare group NPD
• Ukiah Adventist Hospital

  dba Adventist Health Ukiah Valley

  • General Acute Care Hospital
  • Ukiah, CA
  • NPI 1235120676

  Diagnostic Radiology

  Medicare reassignment Care Compare group NPD
• Adventist Health Clearlake Hospital Inc.

  dba Adventist Health Clear Lake

  • Critical Access Hospital
  • Clearlake, CA
  • NPI 1124018031
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Willits Hospital Inc.

  dba Adventist Health Howard Memorial

  • Critical Access Hospital
  • Willits, CA
  • NPI 1356339543
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Hemet, CA
  • NPI 1013433465
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Lancaster, CA
  • NPI 1982863783
  NPD
• Ukiah Adventist Hospital

  dba Adventist Health Howard Pharmacy

  • Community/Retail Pharmacy
  • Willits, CA
  • NPI 1629432968
  NPD
• Adventist Health Clearlake Hospital, Inc

  dba Adventist Health Clear Lake

  • Rural Health Clinic/Center
  • Lakeport, CA
  • NPI 1871063040
  NPD (past)
• Providence Health System - Southern California

  dba Providence Holy Cross Medical Center

  • General Acute Care Hospital
  • Mission Hills, CA
  • NPI 1477587632
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• White Memorial Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1215927470
  Care Compare affiliation

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

{
    "created_epoch": "1446854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1164895520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10842 PORTOFINO PL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900772301",
            "telephone_number": "310-440-0294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10842 PORTOFINO PL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900772301",
            "telephone_number": "310-440-0294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLIN",
        "first_name": "ELLIOT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-07",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G060634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5601 De Soto Ave",
            "city": "Woodland Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913676701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dorothy Kolen
• Koles Place Inc
• Johann Kolev
• Gauri Kolhatkar
• Katherine Koligian
• Talia Kolin, M.D.
• Abigail Kolko
• Jagruti Kolla
• Sarah Elizabeth Koller, M.D.
• Ajay Kolluru

• Diagnostic Radiology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.

Verify at the official NPI Registry.