Active NPI
KD Medical Group Inc
- Family Medicine Physician
- Los Banos, CA
National Provider Identifier
1457522567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A119932
- Legal business name
- KD MEDICAL GROUP 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
- Organization subpart
- Yes
- Parent organization
- KD MEDICAL GROUP INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Karthikeya Devireddy
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A119932 | CA | Primary |
| Internal Medicine Physician | 207R00000X | CA | ||
| Pediatrics Physician | 208000000X | A109208 | CA | |
| Diagnostic Radiology Physician | 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.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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.
-
- Internal Medicine Physician
- Los Banos, CA
- NPI 1780615542
CA, Internal Medicine
-
- Internal Medicine Physician
- Los Banos, CA
- NPI 1316472400
CA, Internal Medicine
-
- Internal Medicine Physician
- Los Banos, CA
- NPI 1407239148
CA, Internal Medicine
-
- Internal Medicine Physician
- Los Banos, CA
- NPI 1295154839
CA, Internal Medicine
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.