Individual provider Active NPI

Kalyani P Randeria, M.D

  • Family Medicine Physician
  • Montebello, CA
National Provider Identifier
1295847689
Registry record updated Apr 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A045174 Issued in CA
Practice address
101 E Beverly Blvd Ste 405
Montebello, CA 90640-4317
Phone
(323) 724-9767
Fax
(323) 724-2722
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A045174 CA Primary

Addresses

Primary practice location

101 E Beverly Blvd Ste 405
Montebello, CA 90640-4317

Mailing address

101 E Beverly Blvd Ste 405
Montebello, CA 90640-4317
Phone (323) 724-9767

Other identifiers 1

IdentifierTypeStateIssuer
00A451740MedicaidCA

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
I20101228000221 CA Practitioner - Family Practice 3274721733 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A045174CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group Family Medicine CurrentSince May 23, 2017 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince May 23, 2017 Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

880 S Atlantic Blvd
Ste 101
Monterey Park, CA 91754
Phone (626) 281-6969

Interoperability endpoints

  • Direct secure messaging: kalyani.randeria.p30@direct.monarchhealthcare.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302652800000",
    "number": "1295847689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E BEVERLY BLVD STE 405",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404317",
            "telephone_number": "323-724-9767",
            "fax_number": "323-724-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E BEVERLY BLVD STE 405",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404317",
            "telephone_number": "323-724-9767",
            "fax_number": "323-724-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDERIA",
        "first_name": "KALYANI",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A045174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A451740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montebello, CA

Sources for this page

Verify at the official NPI Registry.