NPIMap

Individual provider Active NPI

Deeya Paresh Kumar, DO

  • Internal Medicine Physician
  • Redondo Beach, CA
National Provider Identifier
1427517739
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A19554 Issued in CA
Practice address
520 N Prospect Ave
Redondo Beach, CA 90277-3041
Phone
(909) 635-8436
NPI assigned
Mar 16, 2019
Last updated
Aug 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 20A19554 CA Primary

Addresses

Primary practice location

520 N Prospect Ave
Redondo Beach, CA 90277-3041

Mailing address

31700 Temecula Pkwy Ste 2
Temecula, CA 92592-5896

Other practice location 1

31700 Temecula Pkwy Ste 2
Temecula, CA 92592-5896
Phone (951) 600-4337

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
I20221027003173 CA Practitioner - Internal Medicine 1355718701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians

Practice addresses (Care Compare)

520 N Prospect Ave
Suite 103
Redondo Beach, CA 90277-3033
Phone (310) 376-8816

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A19554CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Institute Internal Medicine CurrentSince Nov 1, 2022 Accepting new patients
Providence Medical Institute Internal Medicine Current Accepting new patients
Providence Medical Institute Internal Medicine CurrentSince Nov 1, 2022 Accepting new patients

Locations

520 N Prospect Ave
Ste 103
Redondo Beach, CA 90277
Phone (310) 374-9646

21311 Madrona Ave
Ste 101
Torrance, CA 90503
Phone (310) 792-4012

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1552694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1427517739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31700 TEMECULA PKWY STE 2",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925925896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N PROSPECT AVE",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773041",
            "telephone_number": "909-635-8436"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31700 Temecula Pkwy Ste 2",
            "address_purpose": "LOCATION",
            "city": "Temecula",
            "state": "CA",
            "postal_code": "925925896",
            "country_code": "US",
            "telephone_number": "951-600-4337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "DEEYA",
        "middle_name": "PARESH",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-16",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A19554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

Verify at the official NPI Registry.