NPIMap

Organization Active NPI

KD Medical Group Inc

Doing business as Padres Medical Imaging,Inc.

  • Family Medicine Physician
  • Los Banos, CA
National Provider Identifier
1457522567
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A119932 Issued in CA
Legal business name
KD MEDICAL GROUP INC
Doing business as
Padres Medical Imaging,Inc.
Practice address
311 W I St
Los Banos, CA 93635-3479
Phone
(209) 826-6444
Fax
(209) 826-6464
NPI assigned
Mar 17, 2008
Last updated
Jun 26, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
KD MEDICAL GROUP INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

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

Authorized official

Name
Karthikeya DevireddyNPI 1780615542
Title
Owner / Medical Director
Phone
(209) 826-2222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X A119932 CA Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X CA
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X A109208 CA
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X CA
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

311 W I St
Los Banos, CA 93635-3479

Mailing address

311 W I St
Los Banos, CA 93635-3479
Phone (209) 826-6444

Other names 1

  • Padres Medical Imaging,Inc. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081201000491 CA Part B Supplier - Clinic/Group Practice 2860553468 Receives reassigned benefits from 14 practitioners
Practice locations: Los Banos, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
KD Medical Groupinc

Locations

311 W I St
#B
Los Banos, CA 93635
Phone (209) 826-2222

311 W I St
Ste B
Los Banos, CA 93635
Phone (209) 826-2222

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782432000000",
    "number": "1457522567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W I ST",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936353479",
            "telephone_number": "209-826-6444",
            "fax_number": "209-826-6464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W I ST",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936353479",
            "telephone_number": "209-826-6444",
            "fax_number": "209-826-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KD MEDICAL GROUP INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KD MEDICAL GROUP INC",
        "enumeration_date": "2008-03-17",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A",
        "authorized_official_last_name": "DEVIREDDY",
        "authorized_official_first_name": "KARTHIKEYA",
        "authorized_official_title_or_position": "OWNER / MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "209-826-2222"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A119932",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A109208",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Padres Medical Imaging,Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Banos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.