Individual provider Active NPI

Wagdy William Kades, M.D.

  • Rheumatology Physician
  • Los Angeles, CA
National Provider Identifier
1326080060
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
A56293 Issued in CA
Practice address
1245 Wilshire Blvd Ste 775
Los Angeles, CA 90017-4881
Phone
(213) 484-5397
Fax
(213) 484-9584
NPI assigned
Jun 10, 2006
Last updated
Sep 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X A56293 CA Primary

Addresses

Primary practice location

1245 Wilshire Blvd Ste 775
Los Angeles, CA 90017-4881

Mailing address

1245 Wilshire Blvd Ste 775
Los Angeles, CA 90017-4881
Phone (213) 484-5397

Other identifiers 15

IdentifierTypeStateIssuer
12062138OtherCAM ULTI-PLAN
2224551OtherCACCN PROVIDER NUMBER
00A562930OtherCABLUE SHIELD
731689515OtherCAPPO NEXT
5033747OtherCAAETNA PROVIDER NUMBER
8005463887OtherCAUNITED HEALTH CARE (NEW )
00073212OtherCAMEDICARE RAILROAD
00A562930MedicaidCA
731689515OtherCABLUE CROSS NUMBER
731689515OtherCACHOICE CARE PROVIDER
731689515OtherCACHOICE CARE
731689515OtherCABEECH STREET PROVIDER
11003054OtherCACAOH PROVIDER NUMBER
5444347OtherCACCN PROVIDER NUMBER
731689515OtherCAPHCS PROVIDER NUMBER

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
I20040514001268 CA Practitioner - RheumatologyPractitioner - Internal Medicine 4082604665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1245 Wilshire Blvd
Suite 775
Los Angeles, CA 90017-4881
Phone (213) 484-5397

201 S Alvarado St
Los Angeles, CA 90057-2386

2255 Glades Rd
Suite 228W
Boca Raton, FL 33431-8535

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A56293CAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wagdy W. Kades, M.D. Inc. Rheumatology CurrentSince Jan 1, 2007 Accepting new patients
Providence Saint John's Health Center Past Accepting new patients
Rancho Faculty Medical Associates, Inc. Past Accepting new patients

Locations

1245 Wilshire Blvd
Ste 775
Los Angeles, CA 90017
Phone (213) 484-5397

201 S Alvarado St
Ste 626
Los Angeles, CA 90057
Phone (213) 413-1132

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: wagdy.kades.p86@direct.aara1.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1326080060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BLVD STE 775",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174881",
            "telephone_number": "213-484-5397",
            "fax_number": "213-484-9584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BLVD STE 775",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174881",
            "telephone_number": "213-484-5397",
            "fax_number": "213-484-9584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADES",
        "first_name": "WAGDY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": "A56293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M ULTI-PLAN",
            "identifier": "12062138",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCN PROVIDER NUMBER",
            "identifier": "2224551",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A562930",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPO NEXT",
            "identifier": "731689515",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "5033747",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE (NEW )",
            "identifier": "8005463887",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "00073212",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A562930",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS NUMBER",
            "identifier": "731689515",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHOICE CARE PROVIDER",
            "identifier": "731689515",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHOICE CARE",
            "identifier": "731689515",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEECH STREET PROVIDER",
            "identifier": "731689515",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAOH PROVIDER NUMBER",
            "identifier": "11003054",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCN PROVIDER NUMBER",
            "identifier": "5444347",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS PROVIDER NUMBER",
            "identifier": "731689515",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.