NPIMap

Individual provider Active NPI

David Koller

  • Colon & Rectal Surgery Physician
  • Torrance, CA
National Provider Identifier
1417367517
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
A182814 Issued in CA
Practice address
23451 Madison St Ste 340
Torrance, CA 90505-4762
Phone
(310) 373-6864
NPI assigned
Apr 29, 2014
Last updated
Jun 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X CLP05173 RI
Colon & Rectal Surgery Physician 208C00000X A182814 CA Primary

Addresses

Primary practice location

23451 Madison St Ste 340
Torrance, CA 90505-4762

Mailing address

23451 Madison St Ste 340
Torrance, CA 90505-4762

Other practice location 1

593 Eddy St.
Apc 422
Providence, RI 02903-4923
Phone (401) 606-8399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221130000795 CA Practitioner - Colorectal Surgery (Proctology) 8820306699 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
University of Texas Medical School at Houston, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

23451 Madison St
Suite 300
Torrance, CA 90505-4737
Phone (310) 373-6864

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A182814CAMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Care Foundation CurrentSince Mar 1, 2024 Accepting new patients
Association of South Bay Surgeons CurrentSince Nov 1, 2022 Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients
Providence Health System Southern California Past Accepting new patients

Locations

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

23451 Madison St
Ste 300
Torrance, CA 90505
Phone (310) 375-9994

23451 Madison St
Ste 340
Torrance, CA 90505
Phone (310) 373-6864

3285 Skypark Dr
Torrance, CA 90505
Phone (310) 517-7077

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: dkoller521035@direct.cshs.org

Organizations & group practices 5

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.

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": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1417367517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23451 MADISON ST STE 340",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23451 MADISON ST STE 340",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054762",
            "telephone_number": "310-373-6864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "593 Eddy St.",
            "address_2": "APC 422",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-606-8399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLLER",
        "first_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-29",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "RI",
            "license": "CLP05173",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "CA",
            "license": "A182814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.