Individual provider Active NPI

Ancil K. Philip, MD

  • Surgery Physician
  • Compton, CA
National Provider Identifier
1295943884
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A147208 Issued in CA
Practice address
2251 W Rosecrans Ave Ste 21
Compton, CA 90222-3860
Phone
(424) 529-6755
NPI assigned
May 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 54417-20 WI
Surgery Physician 208600000X A147208 CA Primary

Addresses

Primary practice location

2251 W Rosecrans Ave Ste 21
Compton, CA 90222-3860

Mailing address

PO Box 845833
Los Angeles, CA 90084-5833
Phone (310) 792-3914

Other identifiers 3

IdentifierTypeStateIssuer
1295943884MedicaidWI
PHILIANCOtherWIMERCYCARE INSURANCE
1295943884OtherWIBCBSWI

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20170915001788 CA Practitioner - General Surgery 2769639210 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical College of Wisconsin, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

5475 E la Palma Ave
Anaheim, CA 92807-2075
Phone (714) 279-6088

6640 Alton Pkwy
Irvine, CA 92618-3734
Phone (949) 932-5000

6650 Alton Pkwy
Irvine, CA 92618-3734
Phone (949) 932-5000

6670 Alton Pkwy
Irvine, CA 92618-3734
Phone (949) 932-5000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A147208CAMDSurgery Physician
54417-20WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Luther King Jr Community Medical Foundation CurrentSince Jul 31, 2017 Accepting new patients
Martin Luther King Jr Community Medical Foundation CurrentSince Jul 31, 2017 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 22, 2021 Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 22, 2021 Accepting new patients

Locations

441 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

2251 W Rosecrans Ave
Ste 21
Compton, CA 90222
Phone (424) 338-8792

2215 W Rosecrans Ave
Ste 22
Compton, CA 90222
Phone (424) 529-6755

Organizations & group practices 5

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": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1295943884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845833",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900845833",
            "telephone_number": "310-792-3914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2251 W ROSECRANS AVE STE 21",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902223860",
            "telephone_number": "424-529-6755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILIP",
        "first_name": "ANCIL",
        "middle_name": "K.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "54417-20",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A147208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295943884",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCYCARE INSURANCE",
            "identifier": "PHILIANC",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSWI",
            "identifier": "1295943884",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Compton, CA

Sources for this page

Verify at the official NPI Registry.