Keith S. Feder MD, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

G63788 Issued in CA

Legal business name

KEITH S. FEDER MD, INC.

Practice address

1200 Rosecrans Ave
Suite 208
Manhattan Beach, CA 90266-2462

Phone

(310) 416-9700

Fax

(310) 416-1120

NPI assigned

May 9, 2011

Last updated

Oct 31, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

KEITH S. FEDER MD, INC.As reported in NPPES

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

Authorized official

Name

Keith Feder, MDNPI 1821134123

Title

President

Phone

(310) 416-9700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

West Coast Center for Orthopedic Surgery and Sports Medicine2 organizations share this tax ID, including this one

Part of

West Coast Center for Orthopedic Surgery and Sports Medicine

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• West Coast Center for Orthopedic Surgery and Sports Medicine

  dba Keith S. Feder M.D., Inc.

  • Specialist
  • Manhattan Beach, CA
  • NPI 1851565055
  NPD tax ID

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Cedars-Sinai Marina Hospital

  dba Cedars-Sinai Marina Del Rey Hospital

  • General Acute Care Hospital
  • Marina del Rey, CA
  • NPI 1942269725

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Keith Simon Feder, M.D.

  • Specialist
  • Manhattan Beach, CA
  • NPI 1821134123
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1304899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477872000000",
    "number": "1245522317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 ROSECRANS AVE",
            "address_2": "SUITE 208",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902662462",
            "telephone_number": "310-416-9700",
            "fax_number": "310-416-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 ROSECRANS AVE",
            "address_2": "SUITE 208",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902662462",
            "telephone_number": "310-416-9700",
            "fax_number": "310-416-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH S. FEDER MD, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KEITH S. FEDER MD, INC.",
        "enumeration_date": "2011-05-09",
        "last_updated": "2016-10-31",
        "status": "A",
        "authorized_official_last_name": "FEDER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-416-9700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G63788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Michelle Katz
• Tracy Carol Kawamura, OD
• Rosanne Kay, MD
• Susan Kaye, FNP
• Caroline Fisher Keck
• Diane Renee Kelley, PH.D.
• Lea Kelley, D.C., L.AC.
• Marie Rusher Kelley, M.D.
• Kelly Psychiatric Associates, Inc.
• Patrick Michael Kelly, MD

• Specialist in Manhattan Beach, CA
• Providers in Manhattan Beach, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.