Individual provider Active NPI

Paul A Krogstad, M.D.

  • Pediatric Infectious Diseases Physician
  • Los Angeles, CA
National Provider Identifier
1518074244
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
A45301 Issued in CA
Practice address
10833 Le Conte Ave
12-441 MDCC
Los Angeles, CA 90095-3075
Phone
(310) 206-3952
Fax
(310) 206-0209
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Infectious Diseases Physician 2080P0208X A45301 CA Primary

Addresses

Primary practice location

10833 Le Conte Ave
12-441 MDCC
Los Angeles, CA 90095-3075

Mailing address

10833 Le Conte Ave
12-441 MDCC
Los Angeles, CA 90095-3075
Phone (310) 206-3952

Other identifiers 2

IdentifierTypeStateIssuer
00A453010MedicaidCA
GR0053510MedicaidCA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110405000732 CA Practitioner - Pediatric MedicinePractitioner - Infectious Disease 4587848247 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A45301CAMDPediatric Infectious Diseases Physician
45301CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Pediatric Infectious Diseases CurrentSince Feb 5, 2011 Accepting new patients
UCLA Medical Group Past Accepting new patients
The Regents of the University of California Past Accepting new patients
UCLA Pediatrics Past Accepting new patients

Locations

10833 Le Conte Ave
#12441
Los Angeles, CA 90095
Phone (310) 206-3952

10833 Le Conte Ave
#12311
Los Angeles, CA 90095
Phone (310) 825-9124

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

200 UCLA Medical Plz
Ste 265
Los Angeles, CA 90095
Phone (310) 206-2429

1260 15th St
Ste 1024
Santa Monica, CA 90404
Phone (424) 259-8570

Interoperability endpoints

  • Direct secure messaging: pkrogstad753519@direct.ochin.org
  • Direct secure messaging: pkrogstad38172@direct.uclahealth.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1518074244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "address_2": "12-441 MDCC",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953075",
            "telephone_number": "310-206-3952",
            "fax_number": "310-206-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "address_2": "12-441 MDCC",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953075",
            "telephone_number": "310-206-3952",
            "fax_number": "310-206-0209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROGSTAD",
        "first_name": "PAUL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "CA",
            "license": "A45301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A453010",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0053510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.