NPIMap

Individual provider Active NPI

Lathika Raakesh, MD

  • Nephrology Physician
  • Montebello, CA
National Provider Identifier
1497048672
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A125715 Issued in CA
Practice address
3114 W Beverly Blvd
Montebello, CA 90640
Phone
(323) 726-3868
Fax
(323) 726-3870
NPI assigned
May 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A125715 CA Primary

Addresses

Primary practice location

3114 W Beverly Blvd
Montebello, CA 90640

Mailing address

2149 E Warner Rd Ste 102
Tempe, AZ 85284-3495
Phone (480) 610-6100

Other identifiers 1

IdentifierTypeStateIssuer
100151286MedicaidCA

Other names 1

  • Dr. Lathika S Shetty Former name

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
I20180723002941 CA Practitioner - Nephrology 6709039142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
L a County Nephrology Associates a Medical CorporationGroup PAC ID 3173566536, 11 clinicians

Practice addresses (Care Compare)

3114 W Beverly Blvd
Montebello, CA 90640-2217
Phone (323) 726-3868

Hospital & facility affiliations

  • Centro de Cuidado Renal - Ela, LLC Dialysis facility, Los Angeles, CA, CCN 752578
  • Peritoneal Dialysis Center of America, Inc. Dialysis facility, Montebello, CA, CCN 552585
  • Peritoneal Dialysis Center of America-San Gabriel PC Dialysis facility, Monterey Park, CA, CCN 052684
  • Centro de Cuidado Renal, LLC Dialysis facility, Huntington Park, CA, CCN 752572
  • Rai - East Olympic - Los Angeles Dialysis facility, Los Angeles, CA, CCN 052683
  • Adventist Health White Memorial Hospital, Los Angeles, CA, CCN 050103
  • Community Hospital of Huntington Park Hospital, Huntington Park, CA, CCN 050091
  • Los Angeles Community Hospital Hospital, Los Angeles, CA, CCN 050663
  • Greater El Monte Community Hospital Hospital, South El Monte, CA, CCN 050738
  • East Los Angeles Doctors Hospital Hospital, Los Angeles, CA, CCN 050641

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
82.04
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A125715CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
L a County Nephrology Associates a Medical Corporation CurrentSince May 23, 2024 Accepting new patients
Ahmc Monterey Park Hospital LP Past Accepting new patients
Eladh, LP Past Accepting new patients
Alta Los Angeles Hospital, Inc Past Accepting new patients
Ahmc Greater El Monte Comm Hosp LLC Past Accepting new patients
Northeast Hospital Corporation Past Accepting new patients

Locations

1720 E Cesar E Chavez Ave
Los Angeles, CA 90033
Phone (323) 260-5781

309 W Beverly Blvd
Montebello, CA 90640
Phone (323) 725-4209

3114 W Beverly Blvd
Montebello, CA 90640
Phone (323) 726-1317

3112 W Beverly Blvd
Montebello, CA 90640
Phone (323) 722-2053

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: lathika.raakesh.1@16656.direct.athenahealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1306108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1497048672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2149 E WARNER RD STE 102",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852843495",
            "telephone_number": "480-610-6100",
            "fax_number": "480-610-6189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3114 W BEVERLY BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "90640",
            "telephone_number": "323-726-3868",
            "fax_number": "323-726-3870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAAKESH",
        "first_name": "LATHIKA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-23",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A125715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100151286",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LATHIKA",
            "last_name": "SHETTY",
            "middle_name": "S",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Montebello, CA

Sources for this page

Verify at the official NPI Registry.