Individual provider Active NPI

Jason C Kantor, MD

  • Diagnostic Radiology Physician
  • San Pedro, CA
National Provider Identifier
1356323828
Registry record updated May 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G40284 Issued in CA
Practice address
1300 W 7TH St
San Pedro, CA 90732-3505
Phone
(310) 832-3311
NPI assigned
Nov 18, 2005
Last updated
May 8, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Radiology Physician 2085N0904X G40284 CA
Diagnostic Radiology Physician 2085R0202X G40284 CA Primary

Addresses

Primary practice location

1300 W 7TH St
San Pedro, CA 90732-3505

Mailing address

100 Oceangate
Suite 1000
Long Beach, CA 90802-4312
Phone (562) 590-7400

Other identifiers 2

IdentifierTypeStateIssuer
00G402840MedicaidCA
00G402840OtherCABLUE SHIELD

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
I20070130000765 CA Practitioner - Diagnostic Radiology 7315948551 Reassigns benefits to 13 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Massachusetts Medical School, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1100 N Tustin Ave
Suite a
Santa Ana, CA 92705-3509
Phone (714) 835-6055

16130 Ventura Blvd
Suite 100
Encino, CA 91436-2517
Phone (818) 933-2020

17762 Beach Blvd
Suite 110
Huntington Beach, CA 92647-6860
Phone (585) 218-8007

18785 Brookhurst St
Suite 102
Fountain Valley, CA 92708-7300
Phone (714) 417-9950

230 S Main St
Orange, CA 92868-3851

23961 Calle de la Magdalena
Suite 243
Laguna Hills, CA 92653-3600
Phone (949) 272-2202

2708 E Willow St
Signal Hill, CA 90755-2217
Phone (562) 216-5120

3300 W Coast Hwy
Suite B
Newport Beach, CA 92663-4025
Phone (949) 726-9100

3320 N Los Coyotes Diagonal
Suite 120
Long Beach, CA 90808-3936
Phone (562) 627-0903

408 S Beach Blvd
Suite 106
Anaheim, CA 92804-1873
Phone (714) 995-5471

6440 S St
Lakewood, CA 90713-1713
Phone (562) 299-6230

675 Camino de Los Mares
Suite 101
San Clemente, CA 92673-2836
Phone (949) 493-8799

8750 Wilshire Blvd
Suite 100
Beverly Hills, CA 90211-2708
Phone (310) 689-3100

9191 Westminster
Ave 210
Garden Grove, CA 92844-2751
Phone (714) 784-1657

9191 Westminster Ave
Garden Grove, CA 92844-2751
Phone (714) 784-1657

947 S Anaheim Blvd
Anaheim, CA 92805-5582
Phone (714) 758-9800

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G40284CAMDNuclear Radiology Physician
40284CAMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Norcal Imaging Diagnostic Radiology CurrentSince Jan 23, 2018 Accepting new patients
Norcal Imaging Diagnostic Radiology CurrentSince Jan 23, 2018 Accepting new patients
Beverly Radiology Medical Group Diagnostic Radiology CurrentSince Aug 1, 2006 Accepting new patients
Stockton Diagnostic Imaging Diagnostic Radiology CurrentSince Dec 1, 2017 Accepting new patients
Pronet Imaging Medical Group, Inc. Diagnostic Radiology CurrentSince Dec 1, 2017 Accepting new patients
Desert Advanced Imaging Medical Center Diagnostic Radiology CurrentSince Jan 16, 2018 Accepting new patients
Fresno Imaging Center Diagnostic Radiology CurrentSince Dec 1, 2017 Accepting new patients
Santa Rosa Imaging Medical Center Diagnostic Radiology CurrentSince Dec 1, 2017 Accepting new patients
Diagnostic Radiological Imaging Diagnostic Radiology CurrentSince Dec 1, 2017 Accepting new patients
Modesto Advanced Diagnostic Imaging Medical Center Diagnostic Radiology CurrentSince Dec 1, 2017 Accepting new patients
San Fernando Valley Interventional Radiology and Imaging Center CurrentSince Dec 1, 2017 Accepting new patients
Beverly Radiology Medical Group III Diagnostic Radiology CurrentSince Jul 24, 2006 Accepting new patients
Beverly Radiology Medical Group III Diagnostic Radiology CurrentSince Aug 1, 2006 Accepting new patients
Rad-Image Medical Group Inc Nuclear Radiology Past Accepting new patients
Kern Radiology Medical Group, Inc Diagnostic Radiology Past Accepting new patients
Radmol Pet Center, LLC Diagnostic Radiology Past Accepting new patients
Memrad Medical Group Inc Past Accepting new patients
Santa Ana Tustin Radiology Medical Group Nuclear Radiology Past Accepting new patients

Locations (25 of 32)

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

8750 Wilshire Blvd
Ste 100
Beverly Hills, CA 90211
Phone (310) 689-3100

2601 W Alameda Ave
Ste 101
Burbank, CA 91505
Phone (818) 843-7462

801 S Main St
Ste 101
Corona, CA 92882
Phone (951) 682-1099

16130 Ventura Blvd
Ste 100
Encino, CA 91436
Phone (818) 933-2020

16311 Ventura Blvd
Ste 120
Encino, CA 91436
Phone (818) 817-7707

2201 Walnut Ave
Ste 150
Fremont, CA 94538
Phone (510) 713-1234

6107 N Fresno St
Ste 101
Fresno, CA 93710
Phone (559) 435-4433

6191 N Thesta St
Fresno, CA 93710
Phone (559) 435-7200

9191 Westminster Ave
Ste 105
Garden Grove, CA 92844
Phone (714) 583-6314

250 S 12th Ave
Hanford, CA 93230
Phone (559) 295-2450

2679 Zoe Ave
Huntington Park, CA 90255
Phone (323) 584-3333

16300 Sand Canyon Ave
Ste 102
Irvine, CA 92618
Phone (949) 753-0900

11360 Mountain View Ave
Ste C
Loma Linda, CA 92354
Phone (909) 478-3300

3320 N Los Coyotes Diagonal
Ste 120
Long Beach, CA 90808
Phone (562) 627-0903

3715 E South St
Long Beach, CA 90805
Phone (562) 602-0700

1510 Cotner Ave
Los Angeles, CA 90025
Phone (310) 445-2851

1516 Cotner Ave
Los Angeles, CA 90025
Phone (310) 445-2843

27168 Newport Rd
Ste B
Menifee, CA 92584
Phone (951) 566-5725

157 E Coolidge Ave
Modesto, CA 95350
Phone (209) 524-6800

25395 Hancock Ave
#1101112
Murrieta, CA 92562
Phone (951) 696-4230

3909 Waring Rd
Ste Bc
Oceanside, CA 92056
Phone (760) 630-0014

230 S Main St
Ste 101
Orange, CA 92868
Phone (714) 288-5400

72855 Fred Waring Dr
Palm Desert, CA 92260
Phone (760) 837-1420

2601 E Tahquitz Canyon Way
Palm Springs, CA 92262
Phone (760) 318-2980

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 19

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 19

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399507200000",
    "number": "1356323828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 OCEANGATE",
            "address_2": "SUITE 1000",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024312",
            "telephone_number": "562-590-7400",
            "fax_number": "562-590-7452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W 7TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907323505",
            "telephone_number": "310-832-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANTOR",
        "first_name": "JASON",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2014-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "CA",
            "license": "G40284",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G40284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G402840",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G402840",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pedro, CA

Sources for this page

Verify at the official NPI Registry.