Individual provider Active NPI

Chioma Anuli Kalu, M.D.

  • Pediatrics Physician
  • Canoga Park, CA
National Provider Identifier
1336387018
Registry record updated Aug 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A102218 Issued in CA
Practice address
22030 Sherman Way
Suite #210
Canoga Park, CA 91303-1855
Phone
(818) 857-5991
Fax
(818) 703-0895
NPI assigned
Feb 3, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A102218 CA Primary

Addresses

Primary practice location

22030 Sherman Way
Suite #210
Canoga Park, CA 91303-1855

Mailing address

22030 Sherman Way
Suite #210
Canoga Park, CA 91303-1855
Phone (818) 857-5991

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
I20161013000819 CA Practitioner - Pediatric Medicine 8123267432 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bendito Medical CorporationGroup PAC ID 3870988637, 2 clinicians

Practice addresses (Care Compare)

1780 E Highland Ave
San Bernardino, CA 92404-4618
Phone (909) 402-4601

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A102218CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bendito Pediatrics Inc Current Accepting new patients
Bendito Medical Corporation CurrentSince Feb 1, 2022 Accepting new patients
Medchoice Medical Group Current Accepting new patients
Northeast Valley Health Corporation CurrentSince Aug 24, 2016 Accepting new patients
Northeast Valley Health Corporation CurrentSince Aug 24, 2016 Accepting new patients
Dignity Community Care Past Accepting new patients
West Hills Hospital Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

22030 Sherman Way
Ste 210
Canoga Park, CA 91303
Phone (818) 676-1400

7843 Lankershim Blvd
North Hollywood, CA 91605
Phone (818) 765-8656

1172 N Maclay Ave
San Fernando, CA 91340
Phone (818) 898-1388

1780 E Highland Ave
Sn Bernrdno, CA 92404
Phone (909) 402-4601

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGHHBD/Endpoint/BGHHBD
  • FHIR API: https://api.platform.athenahealth.com/16991/brand/1/csg/1/fhir/r4

Organizations & group practices 8

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": "1233619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343865600000",
    "number": "1336387018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22030 SHERMAN WAY",
            "address_2": "SUITE #210",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913031855",
            "telephone_number": "818-857-5991",
            "fax_number": "818-703-0895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22030 SHERMAN WAY",
            "address_2": "SUITE #210",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913031855",
            "telephone_number": "818-857-5991",
            "fax_number": "818-703-0895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALU",
        "first_name": "CHIOMA",
        "middle_name": "ANULI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-03",
        "last_updated": "2012-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A102218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canoga Park, CA

Sources for this page

Verify at the official NPI Registry.