Beverley Kornder, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A48072 Issued in CA

Practice address

1980 Sequoia Ave
Simi Valley, CA 93063-3167

Phone

(805) 527-1804

Fax

(805) 527-5241

NPI assigned

Jul 4, 2006

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

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

General Practice

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Walter Thomas MD a Medical CorporationGroup PAC ID 4789615386, 2 clinicians

Eastern Ventura Medical Group IncGroup PAC ID 4981628708, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Simi Valley Hospital, Simi Valley, CA, CCN 050236
• Los Robles Hospital & Medical Center Hospital, Thousand Oaks, CA, CCN 050549

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Walter Thomas MD a Medical Corporation

  • Addiction Medicine (Family Medicine) Physician
  • Simi Valley, CA
  • NPI 1598953358
  Medicare reassignment Care Compare group NPD
• Eastern Ventura Medical Group, Inc.

  • Family Medicine Physician
  • Simi Valley, CA
  • NPI 1417900788
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Los Robles Regional Medical Center

  • General Acute Care Hospital
  • Thousand Oaks, CA
  • NPI 1306890389
  Care Compare affiliation
• Simi Valley Hospital and Health Care Services

  • General Acute Care Hospital
  • Simi Valley, CA
  • NPI 1063495190
  Care Compare affiliation

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1477583110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1980 SEQUOIA AVE",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930633167",
            "telephone_number": "805-527-1804",
            "fax_number": "805-527-5241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1980 SEQUOIA AVE",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930633167",
            "telephone_number": "805-527-1804",
            "fax_number": "805-527-5241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNDER",
        "first_name": "BEVERLEY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A48072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Jung Gill Koh, MD
• Kolchansky Dental Corporation
• Mark Kolchansky, D.D.S
• Kenneth Eugene Kolz, D.D.S.
• Howard Ronald Kopel, DDS
• Tessa Margaret Koziol
• Dana Ellen Kramer, R.N.
• Katherine Anne Krier, FNP
• Carrie R Kubota, O.D.
• Manish Kumar, PHARMD

• Family Medicine Physician in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.