Individual provider Active NPI

Andrew P Kelly, MD

  • Diagnostic Radiology Physician
  • Inglewood, CA
National Provider Identifier
1316920895
Registry record updated Feb 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G66498 Issued in CA
Practice address
555 E Hardy Street
Centinela Hospital Medical Center
Inglewood, CA 90301
Phone
(310) 673-4660
NPI assigned
Nov 29, 2005
Last updated
Feb 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G66498 CA Primary

Addresses

Primary practice location

555 E Hardy Street
Centinela Hospital Medical Center
Inglewood, CA 90301

Mailing address

PO Box 5686
Orange, CA 92863-5686
Phone (888) 598-8819

Other identifiers 5

IdentifierTypeStateIssuer
00G664980OtherBLUE SHIELD
00G664980MedicaidCA
00G664980E02OtherCALOPTIMA
050739CF85471OtherTRAILBLAZER
P00225785OtherRAILROAD MEDICARE

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
I20050613000487 CA Practitioner - Diagnostic Radiology 1850335795 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of California, Davis School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centinela Radiology Medical GroupGroup PAC ID 3476440215, 9 clinicians

Practice addresses (Care Compare)

1661 Golden Rain Rd
Seal Beach, CA 90740-4907
Phone (562) 795-6314

222 E Main St
Suite 213 214
Barstow, CA 92311-2361
Phone (780) 242-4444

4650 Lincoln Blvd
Marina del Rey, CA 90292-6306
Phone (310) 823-8911

555 E Hardy St
Inglewood, CA 90301-4011
Phone (310) 673-4660

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score
91.25 of 100Reported as group
Quality
75
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G66498CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Imaging Healthcare, Inc. CurrentSince May 25, 2023 Accepting new patients
United Medical Imaging Healthcare, Inc. CurrentSince May 25, 2023 Accepting new patients
Kerlan-Jobe Orthopaedic Clinic CurrentSince Jan 1, 2014 Accepting new patients
United Medical Imaging Healthcare, Inc. Current Accepting new patients
Centinela Radiology Medical Group Diagnostic Radiology CurrentSince May 1, 2005 Accepting new patients
Beverly Radiology Medical Group III Diagnostic Radiology CurrentSince Feb 1, 2023 Accepting new patients
Beverly Radiology Medical Group III Diagnostic Radiology CurrentSince Feb 1, 2023 Accepting new patients
United Medical Imaging Healthcare, Inc. Past Accepting new patients
United Medical Imaging Healthcare, Inc. Past Accepting new patients
United Medical Imaging Healthcare, Inc. Past Accepting new patients
United Medical Imaging Healthcare, Inc. Past Accepting new patients
United Medical Imaging Healthcare, Inc. Past Accepting new patients
United Medical Imaging Healthcare Inc. Past Accepting new patients
United Medical Imaging Healthcare, Inc. Past Accepting new patients
United Medical Imaging Healthcare, Inc. Past Accepting new patients
United Medical Imaging Healthcare, Inc. Past Accepting new patients
United Medical Imaging Healthcare, Inc. Past Accepting new patients
United Medical Imaging Healthcare, Inc. Diagnostic Radiology Past Accepting new patients
United Medical Imaging Healthcare, Inc. Past Accepting new patients
United Medical Imaging Healthcare, Inc. Past Accepting new patients
United Medical Imaging Healthcare, Inc. Past Accepting new patients
United Medical Imaging Healthcare, Inc. Past Accepting new patients
United Medical Imaging Healthcare, Inc. Past Accepting new patients
United Medical Imaging Healthcare, Inc. Past Accepting new patients
United Medical Imaging Healthcare, Inc. Past Accepting new patients
United Medical Imaging Healthcare, Inc. Past Accepting new patients
United Medical Imaging Healthcare Inc. Past Accepting new patients
United Medical Imaging Healthcare, Inc. Past Accepting new patients
United Medical Imaging Healthcare, Inc. Past Accepting new patients
United Medical Imaging Healthcare, Inc. Past Accepting new patients
United Medical Imaging Healthcare, Inc. Past Accepting new patients
United Medical Imaging Healthcare, Inc. Past Accepting new patients
United Medical Imaging Healthcare, Inc. Past Accepting new patients
United Medical Imaging Healthcare, Inc. Past Accepting new patients

Locations (25 of 26)

18523 Corwin Rd
Ste J
Apple Valley, CA 92307
Phone (760) 242-4444

222 E Main St
Ste 213214
Barstow, CA 92311
Phone (780) 242-4444

8750 Wilshire Blvd
Ste 100
Beverly Hills, CA 90211
Phone (310) 689-3100

2601 W Alameda Ave
Ste 101
Burbank, CA 91505
Phone (818) 843-7462

801 S Main St
Ste 101
Corona, CA 92882
Phone (951) 682-1099

801 S Main St
Ste 205
Corona, CA 92882
Phone (951) 351-1025

16130 Ventura Blvd
Ste 100
Encino, CA 91436
Phone (818) 933-2020

6107 N Fresno St
Ste 101
Fresno, CA 93710
Phone (559) 435-4433

9191 Westminster Ave
Ste 105
Garden Grove, CA 92844
Phone (714) 583-6314

250 S 12th Ave
Hanford, CA 93230
Phone (559) 295-2450

2679 Zoe Ave
Huntington Park, CA 90255
Phone (323) 584-3333

110 S La Brea Ave
Ste 150
Inglewood, CA 90301
Phone (310) 671-6000

555 E Hardy St
Inglewood, CA 90301
Phone (310) 419-8636

11360 Mountain View Ave
Ste C
Loma Linda, CA 92354
Phone (909) 478-3300

3320 N Los Coyotes Diagonal
Ste 120
Long Beach, CA 90808
Phone (562) 627-0903

3715 E South St
Long Beach, CA 90805
Phone (562) 602-0700

3513 Whittier Blvd
Los Angeles, CA 90023
Phone (323) 262-1814

6801 Park Ter
Ste 100
Los Angeles, CA 90045
Phone (310) 665-7180

27168 Newport Rd
Ste B
Menifee, CA 92584
Phone (951) 566-5725

26522 La Alameda
Ste 170
Mission Viejo, CA 92691
Phone (949) 535-2100

25395 Hancock Ave
#1101112
Murrieta, CA 92562
Phone (951) 696-4230

3909 Waring Rd
Ste Bc
Oceanside, CA 92056
Phone (760) 630-0014

1661 Golden Rain Rd
Ste Radiology
Seal Beach, CA 90740
Phone (562) 795-6314

2950 Sycamore Dr
Ste 102
Simi Valley, CA 93065
Phone (805) 357-0067

300 Lombard St
Thousand Oaks, CA 91360
Phone (805) 495-1220

Organizations & group practices 34

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 34

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424649600000",
    "number": "1316920895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5686",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928635686",
            "telephone_number": "888-598-8819",
            "fax_number": "714-571-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 E HARDY STREET",
            "address_2": "CENTINELA HOSPITAL MEDICAL CENTER",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "90301",
            "telephone_number": "310-673-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ANDREW",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2015-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G66498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G664980",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G664980",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALOPTIMA",
            "identifier": "00G664980E02",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAILBLAZER",
            "identifier": "050739CF85471",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00225785",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

Verify at the official NPI Registry.