Christian Michael Kondan, PA-C
Individual provider Active NPI Physician Assistant · Lakeside, CA
NPI 1255073748 · NPPES record last updated Apr 13, 2022
Key facts
- NPI
- 1255073748
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA60948 (CA)
- Practice address
- 13523 Sohail St
Lakeside, CA 92040-4762 - Phone
- (619) 564-9461
- NPI assigned
- Apr 13, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Smi Imaging LLC
Simonmed Imaging Florida LLC
Health Diagnostics of California a Professional Corporation
Practice addresses (Care Compare)
Whitehouse, TX 75791
Phone (480) 306-6949
10125 W Colonial Dr
114 Simonmed Imaging Ocoee II
Ocoee, FL 34761-4212
Phone (407) 531-7100
10440 E Riggs Rd
110 Simonmed Imaging Sun Lakes
Sun Lakes, AZ 85248-7751
Phone (480) 883-6860
10561 Jeffreys St
Suite 111
Henderson, NV 89052-4267
Phone (702) 832-0116
10815 W McDowell Rd
102 Simonmed Imaging Avondale
Avondale, AZ 85392-5009
Phone (623) 433-0121
1111 S Dobson Rd
105 Simonmed Imaging Mesa Desert
Mesa, AZ 85202-3902
Phone (480) 964-4995
1125 Miranda LN
Kissimmee, FL 34741-0763
Phone (689) 204-0153
11375 S Sam Houston Pkwy W
150 Simonmed Imaging Beltway
Houston, TX 77031-2347
Phone (346) 335-8561
130 S 63Rd St
123 Simonmed Imaging Baywood
Mesa, AZ 85206-1604
Phone (480) 264-4900
1345 E McKellips Rd
106 Simonmed Imaging McKellips
Mesa, AZ 85203-2721
Phone (480) 265-8101
13624 W Camino del Sol
300 Simonmed Imaging Sun City West
Sun City West, AZ 85375-3402
Phone (623) 214-6609
13940 N US Hwy 441 201
Simonmed Imaging the Villages
The Villages, FL 32159-8909
Phone (352) 241-7448
1425 S Greenfield Rd BLDG 2
Mesa, AZ 85206-5505
14823 W Bell Rd
110 Simonmed Imaging Stadium Village
Surprise, AZ 85374-7604
Phone (623) 302-7900
1501 River Pointe Dr
Suite 180
Conroe, TX 77304-2865
Phone (832) 838-4185
15775 Laguna Canyon Rd
Suite 140
Irvine, CA 92618-3190
Phone (949) 522-8120
16550 Southwest Fwy
Suite C
Sugar Land, TX 77479-2328
Phone (346) 900-8010
17191 St Lukes Way
110 Simonmed Imaging College Park
The Woodlands, TX 77384-8043
Phone (281) 720-8600
1845 W Orange Grove Rd
103 Simonmed Imaging Orange Grove
Tucson, AZ 85704-1147
Phone (520) 230-4900
1960 W Frye Rd
1 Simonmed Imaging Dobson Womens Center
Chandler, AZ 85224-6238
Phone (480) 306-7340
208 W Oak St
Simonmed Imaging Kissimmee
Kissimmee, FL 34741-4420
Phone (407) 846-8700
2080 W Southern Ave BLDG C
Simonmed Imaging Apache Junction
Apache Junction, AZ 85120-7653
Phone (480) 474-5960
20830 N Tatum Blvd
190 Simonmed Imaging Desert Ridge
Phoenix, AZ 85050-7253
Phone (480) 306-7900
21115 E Rittenhouse Rd
Simonmed Imaging Rittenhouse
Queen Creek, AZ 85142-4838
Phone (480) 371-3491
2256 W Holcombe Blvd
Simonmed Imaging Med Center
Houston, TX 77030-2008
Phone (346) 335-8519
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (6 enrollments) in CA, FL, WI, AZ, NV, TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221109002138 | CA | Practitioner - Physician Assistant | 4688041361 | Reassigns benefits to 6 organizations |
| I20241227001955 | FL | Practitioner - Physician Assistant | 4688041361 | Reassigns benefits to 1 organization |
| I20250114001148 | WI | Practitioner - Physician Assistant | 4688041361 | Reassigns benefits to 1 organization |
| I20250218000212 | AZ | Practitioner - Physician Assistant | 4688041361 | Reassigns benefits to 1 organization |
| I20250225003547 | NV | Practitioner - Physician Assistant | 4688041361 | Reassigns benefits to 2 organizations |
| I20250614000232 | TX | Practitioner - Physician Assistant | 4688041361 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA60948 | CA | MD | Physician Assistant |
Practice roles (9 of 11)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neighborhood Healthcare | Current |
Accepting new patients | |
| Smi Imaging, LLC | Current |
Accepting new patients | |
| Smi Imaging LLC | Current |
Accepting new patients | |
| Smi Imaging LLC | Current |
Accepting new patients | |
| Simonmed Imaging Florida LLC | Current |
Accepting new patients | |
| Neighborhood Healthcare | Current |
Accepting new patients | |
| Health Diagnostics of California a Professional Corporation | Current |
Accepting new patients | |
| Simonmed Reno PLLC | Current |
Accepting new patients | |
| Simonmed Imaging Florida LLC | Current |
Accepting new patients |
Locations
16220 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254
1845 W Orange Grove Rd
Ste 103
Tucson, AZ 85704
Phone (520) 230-4900
155 N San Vicente Blvd
#1182
Beverly Hills, CA 90211
Phone (323) 433-7800
8370 Wilshire Blvd
Ste 110
Beverly Hills, CA 90211
Phone (323) 966-0000
855 E Madison Ave
El Cajon, CA 92020
Phone (619) 440-2751
425 N Date St
Escondido, CA 92025
Phone (760) 737-2035
15775 Laguna Canyon Rd
Irvine, CA 92618
Phone (617) 455-2048
265 Citrus Tower Blvd
Ste 100
Clermont, FL 34711
Phone (352) 241-7440
208 W Oak St
Kissimmee, FL 34741
Phone (407) 788-2888
730 Goodlette Rd
Ste 101
Naples, FL 34102
Phone (239) 262-5151
2121 S Orange Ave
Orlando, FL 32806
Phone (407) 514-1870
3061 S Maryland Pkwy
Ste 102
Las Vegas, NV 89109
Phone (702) 369-4570
590 Eureka Ave
Reno, NV 89512
Phone (775) 323-5083
24600 Katy Fwy
Katy, TX 77494
Phone (346) 527-0245
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Interoperability endpoints
- christian.kondan.p1@direct.arch.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA60948 | CA | Yes |
Addresses
Primary practice location
13523 Sohail St
Lakeside, CA 92040-4762
Mailing address
13523 Sohail St
Lakeside, CA 92040-4762
Other providers in Lakeside, CA
- James a. Cloyd DDS Inc.
- Omar Johnson
- Robert Johnson
- Cassandra Mary Kauffman
- Vania Knight
- John E. Kramer
- Sarah Kyanza Kyanza
- Lakeside Fire Protection
- Lakeside Union
- Larry J Marshall MD a Professional Corporation
All providers in Lakeside, CA · Physician Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.