Individual provider Active NPI

Kakarla V Chalam, MD

  • Ophthalmology Physician
  • Loma Linda, CA
National Provider Identifier
1336112812
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
C149136 Issued in CA
Practice address
11370 Anderson St Ste 1800
Loma Linda, CA 92354-3450
Phone
(909) 558-2154
Fax
(909) 558-2180
NPI assigned
Feb 7, 2006
Last updated
Jun 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME72613 FL
Ophthalmology Physician 207W00000X C149136 CA Primary

Addresses

Primary practice location

11370 Anderson St Ste 1800
Loma Linda, CA 92354-3450

Mailing address

11370 Anderson St Ste 1800
Loma Linda, CA 92354-3450
Phone (909) 558-2154

Other practice location 1

580 West 8th Street
UFJP Ophthalmology
Jacksonville, FL 32209-6511
Phone (904) 244-9390

Other practice location 2

4244 Riverwalk Pkwy Ste 100
Riverside, CA 92505-3372
Phone (909) 558-2154

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, PA, CA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20110401000728 FL Practitioner - Ophthalmology 9335323153 Reassigns benefits to 1 organization
I20170510000015 PA Practitioner - Ophthalmology 9335323153
I20170717002582 CA Practitioner - Ophthalmology 9335323153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11370 Anderson St
Loma Linda, CA 92354-3450

26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone (951) 486-4000

81 Highland Springs Ave
Beaumont, CA 92223-3170
Phone (909) 558-4000

File Number
Suite 54701
Los Angeles, CA 90074-4701

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C149136CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
University of Florida Jacksonville Physicians Inc Ophthalmology CurrentSince Nov 1, 1999 Accepting new patients
Faculty Physicians and Surgeons of Llusm Ophthalmology CurrentSince Jul 15, 2017 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jul 15, 2017 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Nov 1, 1999 Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Springfield Hospital Inc. Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Loma Linda University Children's Hospital Past Accepting new patients
Baptist Medical Center of Nassau Inc Past Accepting new patients
Shands Teaching Hospital and Clinics Inc Past Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

11370 Anderson St
#1800
Loma Linda, CA 92354
Phone (909) 558-2154

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

11370 Anderson St
Ste 1800
Loma Linda, CA 92354
Phone (909) 558-2154

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610

26520 Cactus Ave
Ste 2021
Moreno Valley, CA 92555
Phone (951) 486-5700

4244 Riverwalk Pkwy
Ste 100
Riverside, CA 92505
Phone (909) 558-2154

2195 Club Center Dr
Ste A
Sn Bernrdno, CA 92408
Phone (909) 835-1750

580 W 8th St
Jacksonville, FL 32209
Phone (904) 244-3960

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

Interoperability endpoints

  • Direct secure messaging: kchalam137329@direct.llu.edu

Organizations & group practices 13

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 13

Hospital & facility affiliations 2

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": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1336112812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11370 ANDERSON ST STE 1800",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543450",
            "telephone_number": "909-558-2154",
            "fax_number": "909-558-2180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11370 ANDERSON ST STE 1800",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543450",
            "telephone_number": "909-558-2154",
            "fax_number": "909-558-2180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "580 West 8th Street",
            "address_2": "UFJP Ophthalmology",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322096511",
            "country_code": "US",
            "telephone_number": "904-244-9390",
            "fax_number": "904-244-9391",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4244 Riverwalk Pkwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925053372",
            "country_code": "US",
            "telephone_number": "909-558-2154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHALAM",
        "first_name": "KAKARLA",
        "middle_name": "V",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME72613",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "C149136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.