Neal Dexter Ketchum

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

95001818 Issued in CA

Practice address

500 Parnassus Ave
San Francisco, CA 94143-2203

Phone

(415) 883-0944

Fax

(415) 476-9516

NPI assigned

Apr 7, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

San Joaquin Faculty Medical GroupGroup PAC ID 4082631395, 126 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Joaquin General Hospital Hospital, French Camp, CA, CCN 050167

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• San Joaquin Faculty Medical Group

  • Internal Medicine Physician
  • French Camp, CA
  • NPI 1225063761
  Medicare reassignment Care Compare group NPD
• County of San Joaquin

  dba San Joaquin General Hospital

  • General Acute Care Hospital
  • French Camp, CA
  • NPI 1801830583
  Medicare reassignment NPD
• UCSF Medical Group Business Services

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1477624104
  Medicare reassignment NPD
• University Anesthesia Medical Group

  • Anesthesiology Physician
  • San Francisco, CA
  • NPI 1528137296
  Medicare reassignment NPD
• University of California San Francisco

  dba UCSF Pediatrics Group

  • Pediatrics Physician
  • San Francisco, CA
  • NPI 1861578973
  Medicare reassignment NPD
• County of San Joaquin

  dba San Joaquin County Clinic Manteca

  • Multi-Specialty Clinic/Center
  • Manteca, CA
  • NPI 1417407636
  NPD
• UCSF Medical Group Business Services

  dba UCSF Orthotic and Prosthetic Center - Gateway Medical Building

  • Health Service Clinic/Center
  • San Francisco, CA
  • NPI 1194115246
  NPD
• University of California San Francisco

  dba UCSF Surgical Group

  • Surgery Physician
  • San Francisco, CA
  • NPI 1346329380
  NPD
• University of California San Francisco

  dba UCSF Outpatient Pharmacy at Parnassus

  • Community/Retail Pharmacy
  • San Francisco, CA
  • NPI 1659141711
  NPD

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

• County of San Joaquin

  dba San Joaquin General Hospital

  • General Acute Care Hospital
  • French Camp, CA
  • NPI 1992870430
  Care Compare affiliation

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732838400000",
    "number": "1225770670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 PARNASSUS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432203",
            "telephone_number": "415-883-0944",
            "fax_number": "415-476-9516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PARNASSUS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432203",
            "telephone_number": "415-883-0944",
            "fax_number": "415-476-9516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Bodin Cir",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CA",
            "postal_code": "945351809",
            "country_code": "US",
            "telephone_number": "707-423-3490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KETCHUM",
        "first_name": "NEAL",
        "middle_name": "DEXTER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-07",
        "last_updated": "2024-11-29",
        "certification_date": "2024-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "826887",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95001818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lawrence Kessler, REHS
• Nadine Kessler, PT
• Reuben Jack Kessler, ACSW
• Julie Kesterson, RN
• Ketamine Treatment Centers of California PC (Actify Neurotherapies)
• Ruhama Ketema
• Ketetha Olengue MD Incorporated (Ordinary Psychiatry)
• Ian Todd Kettelkamp
• Edmund C Keung, M.D.
• Lisa Keung, R.D.

• Certified Registered Nurse Anesthetist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Certified Registered Nurse Anesthetist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.