Hazel McKillop, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

A50837 Issued in CA

Practice address

12900 Avalon Blvd
Los Angeles, CA 90061-2734

Phone

(310) 370-5888

NPI assigned

Jul 21, 2006

Last updated

Aug 19, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Internal MedicineAlso: Critical Care (Intensivists), Pulmonary Disease

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Innley Medical Group Inc.

  • Pulmonary Disease Physician
  • Lawndale, CA
  • NPI 1770505620
  Medicare reassignment NPD Authorized official
• Centinela Medical Group

  • General Practice Physician
  • Inglewood, CA
  • NPI 1902936099
  Medicare reassignment NPD
• Feras and Hisham a Medical Corporation

  dba Family First Medical Clinic

  • Health Service Clinic/Center
  • Pomona, CA
  • NPI 1700055274
  NPD
• Habona Services

  • Non-Surgical Family Planning Clinic/Center
  • Los Angeles, CA
  • NPI 1023517315
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439942400000",
    "number": "1396766994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2199",
            "address_2": "1455 W REDONDO BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "90247",
            "telephone_number": "310-370-5888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12900 AVALON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900612734",
            "telephone_number": "310-370-5888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKILLOP",
        "first_name": "HAZEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2015-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A50837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A508371",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle McKeon, MSW
• Derek James McKernan, MSW, LCSW
• Breana McKie
• Maira A McKiernan
• Queana McKillian
• Emma McKim
• Marianne McKim, OTR
• Rebecca Elizabeth McKim, PT, DPT
• Caroline McKinley
• Donnie Ray McKinley Jr.

• Pulmonary Disease Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Pulmonary Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.