Individual provider Active NPI

Cheryl L Kellogg, M.D.

  • Specialist
  • Laguna Niguel, CA
National Provider Identifier
1376561027
Registry record updated Apr 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
C050266 Issued in CA
Practice address
30131 Town Center Dr
Suite 204
Laguna Niguel, CA 92677-2034
Phone
(949) 342-1780
Fax
(949) 342-1786
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X C050266 CA Primary

Addresses

Primary practice location

30131 Town Center Dr
Suite 204
Laguna Niguel, CA 92677-2034

Mailing address

30100 Town Center Dr
Suite O #437
Laguna Niguel, CA 92677-2064
Phone (949) 342-1780

Other identifiers 3

IdentifierTypeStateIssuer
W13226AOtherCAMEDICARE GROUP NUMBER
ZZZ47948ZOtherCABLUE SHIELD
C050266OtherCASTATE LICENSE #

Other names 1

  • Dr. Cheryl L Patterson Former name

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
I20110126000386 CA Practitioner - Internal Medicine 7719166511 Reassigns benefits to 1 organization

Care Compare profile

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

Practice addresses (Care Compare)

30131 Town Ctr Dr
Suite 215
Laguna Niguel, CA 92677-2033
Phone (949) 499-1137

Hospital & facility affiliations

  • Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567
  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224
  • Memorialcare Saddleback Medical Center Hospital, Laguna Hills, CA, CCN 050603

Merit-based Incentive Payment System (MIPS)

Final score
97.92 of 100Reported as individual
Quality
98.6
Improvement activities
40
Cost
94.95

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C050266CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Cheryl L Kellogg MD Inc CurrentSince Jan 1, 2011 Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients

Locations

30131 Town Center Dr
Ste 215
Laguna Niguel, CA 92677
Phone (949) 441-7151

30100 Town Center Dr
Ste O
Laguna Niguel, CA 92677
Phone (949) 489-5564

30100 Town Center Dr
#O437
Laguna Niguel, CA 92677

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333670400000",
    "number": "1376561027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30100 TOWN CENTER DR",
            "address_2": "SUITE O #437",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926772064",
            "telephone_number": "949-342-1780",
            "fax_number": "949-342-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30131 TOWN CENTER DR",
            "address_2": "SUITE 204",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926772034",
            "telephone_number": "949-342-1780",
            "fax_number": "949-342-1786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLOGG",
        "first_name": "CHERYL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2012-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "C050266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "W13226A",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ47948Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "C050266",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHERYL",
            "last_name": "PATTERSON",
            "middle_name": "L",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Laguna Niguel, CA

Sources for this page

Verify at the official NPI Registry.