Individual provider Active NPI

Kevin James Hardiman, D.O.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Los Angeles, CA
National Provider Identifier
1336483718
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
20A12516 Issued in CA
Practice address
1200 N State St # 1060
Los Angeles, CA 90089-1001
Phone
(619) 807-8919
NPI assigned
Nov 26, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 20A12516 CA Primary

Addresses

Primary practice location

1200 N State St # 1060
Los Angeles, CA 90089-1001

Mailing address

1245 N Laurel Ave Apt 6
West Hollywood, CA 90046-5135
Phone (619) 807-8919

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20140912002136 CA Practitioner - Emergency Medicine 6204055817 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A12516CAMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Mar 23, 2023 Accepting new patients
Pacific Emergency Providers, a Prof. Corp. CurrentSince Aug 14, 2015 Accepting new patients
La Jolla Observation Medicine CurrentSince Jul 12, 2019 Accepting new patients
Cep America-California CurrentSince May 5, 2023 Accepting new patients
Scripps Health Current Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Cep America - California CurrentSince May 5, 2023 Accepting new patients
Cep America - California Current Accepting new patients

Locations

751 Medical Center Ct
#1182
Chula Vista, CA 91911

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

4077 5th Ave
#M
San Diego, CA 92103
Phone (619) 260-7000

4077 5th Ave
San Diego, CA 92103
Phone (619) 260-7245

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

23845 McBean Pkwy
Valencia, CA 91355
Phone (661) 200-2000

Interoperability endpoints

  • Direct secure messaging: khardiman@exer.direct.codonix.com
  • Direct secure messaging: khardiman286584@scrippshlth.medalliesdirect.net

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": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1336483718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 N LAUREL AVE APT 6",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900465135",
            "telephone_number": "619-807-8919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST # 1060",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900891001",
            "telephone_number": "619-807-8919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDIMAN",
        "first_name": "KEVIN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-26",
        "last_updated": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "CA",
            "license": "20A12516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "13652 Cantara St",
            "city": "Panorama City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914025423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.