Individual provider Active NPI

Michael W Kistler, M.D.

  • Diagnostic Radiology Physician
  • San Diego, CA
National Provider Identifier
1508811175
Registry record updated Sep 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G17434 Issued in CA
Practice address
501 Washington St
Ste 510
San Diego, CA 92103-2231
Phone
(619) 819-6501
NPI assigned
May 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G17434 CA Primary

Addresses

Primary practice location

501 Washington St
Ste 510
San Diego, CA 92103-2231

Mailing address

PO Box 910514
San Diego, CA 92191-0514

Other identifiers 1

IdentifierTypeStateIssuer
00G174340MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, NY, WA3 enrollments
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210920002402 CO Practitioner - Diagnostic Radiology 0446209225 Reassigns benefits to 2 organizations
I20240814003981 NY Practitioner - Diagnostic Radiology 0446209225 Reassigns benefits to 2 organizations
I20241025001758 WA Practitioner - Diagnostic Radiology 0446209225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.67 of 100Reported as group
Quality
100
Improvement activities
40
Cost
85.3

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G17434CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grays Harbor Community Hospital CurrentSince Jul 21, 2024 Accepting new patients
Central Valley Community Medical Imaging Diagnostic Radiology CurrentSince Dec 1, 2021 Accepting new patients
Grays Harbor Community Hospital CurrentSince Jul 21, 2024 Accepting new patients
The Brookdale Hospital Medical Center CurrentSince Dec 7, 2024 Accepting new patients
Brookdale Hospital Medical Center CurrentSince Dec 7, 2024 Accepting new patients
Interfaith Professional Physician Services, P.C. Diagnostic Radiology CurrentSince Jun 1, 2024 Accepting new patients
Riverside Radiology Medical Group Inc Diagnostic Radiology CurrentSince Nov 1, 2021 Accepting new patients
Open System MRI LLC Diagnostic Radiology Past Accepting new patients
Open Air MRI Centers Medical Group, Inc. Diagnostic Radiology Past Accepting new patients
J.Bruce Jacobs, M.D., Inc. Diagnostic Radiology Past Accepting new patients
IHS Radiology Medical Group, Inc. Diagnostic Radiology Past Accepting new patients
Imaging Healthcare Specialists Medical Group, Inc. Diagnostic Radiology PastSince Oct 14, 2013 Accepting new patients
Physicians Radiology Medical Group, Inc. Diagnostic Radiology Past Accepting new patients

Locations

18300 US Highway 18
Apple Valley, CA 92307
Phone (760) 424-2311

600 N Highland Springs Ave
Banning, CA 92220
Phone (833) 443-6287

1770 Iowa Ave
Ste 280
Riverside, CA 92507
Phone (661) 948-4781

4510 Brockton Ave
Ste 175
Riverside, CA 92501
Phone (951) 786-5100

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

1805 Medical Center Dr
Sn Bernrdno, CA 92411
Phone (909) 877-6333

2101 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 881-4305

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

915 Anderson Dr
Aberdeen, WA 98520
Phone (360) 532-8330

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789257600000",
    "number": "1508811175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 910514",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921910514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 WASHINGTON ST",
            "address_2": "STE 510",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032231",
            "telephone_number": "619-819-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISTLER",
        "first_name": "MICHAEL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2026-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G17434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G174340",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.