Individual provider Active NPI

Kyu Choi, MD

  • Diagnostic Radiology Physician
  • Ventura, CA
National Provider Identifier
1316986938
Registry record updated Aug 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
C51176 Issued in CA
Practice address
147 N Brent St
Radiology Department
Ventura, CA 93003-2809
Phone
(805) 652-5028
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2012

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 C51176 CA Primary

Addresses

Primary practice location

147 N Brent St
Radiology Department
Ventura, CA 93003-2809

Mailing address

20 Executive Park
Ste 155
Irvine, CA 92614-6736
Phone (949) 263-8620

Other identifiers 2

IdentifierTypeStateIssuer
00C511760MedicaidCA
00C511760OtherCABLUE SHIELD OF CA

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
I20040429001438 CA Practitioner - Diagnostic Radiology 9436146487 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beverly Radiology Medical Group IIIGroup PAC ID 3476466376, 327 clinicians

Practice addresses (Care Compare)

3900 Sherman Dr
Suite 100200
Riverside, CA 92503-4006
Phone (951) 682-1099

Merit-based Incentive Payment System (MIPS)

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

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C51176CAMDDiagnostic Radiology Physician
51176CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Beverly Radiology Medical Group III Diagnostic Radiology CurrentSince May 15, 2024 Accepting new patients
Community Imaging Medical Group Inc Diagnostic Radiology Past Accepting new patients

Locations

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

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

Organizations & group practices 3

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345075200000",
    "number": "1316986938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 EXECUTIVE PARK",
            "address_2": "STE 155",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146736",
            "telephone_number": "949-263-8620",
            "fax_number": "800-503-7224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 N BRENT ST",
            "address_2": "RADIOLOGY DEPARTMENT",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032809",
            "telephone_number": "805-652-5028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "KYU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2012-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "C51176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C511760",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "00C511760",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.