NPIMap

Organization Active NPI

KD Medical Group Inc

  • Podiatrist
  • Los Banos, CA
National Provider Identifier
1306372198
Registry record updated Jun 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5321 Issued in CA
Legal business name
KD MEDICAL GROUP INC
Practice address
400 W I St
Suite C
Los Banos, CA 93635-3459
Phone
(209) 827-2766
Fax
(209) 827-2733
NPI assigned
May 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2017

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

Authorized official

Name
Dr. Karthikeya Devireddy, M.D.NPI 1780615542
Title
Medical Director
Phone
(209) 826-2222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 5321 CA Primary
Customized Equipment (DME) 332BC3200X 5321 CA

Addresses

Primary practice location

400 W I St
Suite C
Los Banos, CA 93635-3459

Mailing address

311 W I St
Los Banos, CA 93635-3479
Phone (209) 826-2222

Other names 1

  • Foot & Ankle Podiatric & Orthopedic Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170530001600 CA DME Supplier - Physician - General Practice 2860553468 Practice locations: Los Banos, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1032613KD Medical Group Inc400 W I St, Los Banos, CA 93635ComplianceAug 4, 2026

National Provider Directory

National Provider Directory

Locations

400 W I St
Ste D
Los Banos, CA 93635
Phone (209) 255-2305

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498435200000",
    "number": "1306372198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W I ST",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936353479",
            "telephone_number": "209-826-2222",
            "fax_number": "209-826-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W I ST",
            "address_2": "SUITE C",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936353459",
            "telephone_number": "209-827-2766",
            "fax_number": "209-827-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KD MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-06-26",
        "status": "A",
        "authorized_official_last_name": "DEVIREDDY",
        "authorized_official_first_name": "KARTHIKEYA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "209-826-2222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "5321",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "CA",
            "license": "5321",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foot & Ankle Podiatric & Orthopedic Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Banos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2017; 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.