Individual provider Active NPI

Kenneth Bruce Horwitz, M.D.

  • Internal Medicine Physician
  • Anaheim, CA
National Provider Identifier
1225138829
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G59007 Issued in CA
Practice address
1211 W la Palma Ave
Suite 207
Anaheim, CA 92801-2815
Phone
(714) 772-8282
Fax
(714) 772-6493
NPI assigned
Sep 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G59007 CA Primary

Addresses

Primary practice location

1211 W la Palma Ave
Suite 207
Anaheim, CA 92801-2815

Mailing address

PO Box 15090
Anaheim, CA 92803-5090
Phone (714) 772-8282

Other identifiers 2

IdentifierTypeStateIssuer
00G590070MedicaidCA
P00402397OtherCAMEDICARE RR

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
I20041124000256 CA Practitioner - Internal MedicinePractitioner - Geriatric Medicine 7315902855 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G59007CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chest and Critical Care Consultants Internal Medicine CurrentSince Jul 1, 2006 Accepting new patients
Chest and Critical Care Consultants a Medical Group Internal Medicine Current Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients
Chest and Critical Care Consultants a Medical Group Internal Medicine Past Accepting new patients
Massachusetts General Physicians Organization Inc Internal Medicine Past Accepting new patients
Ahmc Whittier Hospital Medical Center LP Past Accepting new patients
University of California Irvine Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients

Locations

1211 W La Palma Ave
Ste 207
Anaheim, CA 92801
Phone (714) 772-8282

1801 W Romneya Dr
Ste 409
Anaheim, CA 92801
Phone (714) 772-8282

1211 W La Palma Ave
Ste 404
Anaheim, CA 92801
Phone (714) 772-1030

5451 La Palma Ave
Ste 19
La Palma, CA 90623
Phone (714) 521-9126

999 N Tustin Ave
Ste 1
Santa Ana, CA 92705
Phone (714) 836-6800

13522 Newport Ave
Ste 102
Tustin, CA 92780
Phone (714) 573-8200

14350 Whittier Blvd
Ste 315
Whittier, CA 90605
Phone (562) 464-2163

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1225138829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15090",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928035090",
            "telephone_number": "714-772-8282",
            "fax_number": "714-772-6493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE",
            "address_2": "SUITE 207",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012815",
            "telephone_number": "714-772-8282",
            "fax_number": "714-772-6493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORWITZ",
        "first_name": "KENNETH",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-24",
        "last_updated": "2023-03-07",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G59007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G590070",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00402397",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.