Individual provider Active NPI

Kaitlyn Rebecca Ike, MD

  • Family Medicine Physician
  • Ventura, CA
National Provider Identifier
1518302785
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A134653 Issued in CA
Practice address
300 Hillmont Ave
Ventura, CA 93003-1651
Phone
(805) 652-6556
NPI assigned
May 1, 2013
Last updated
Aug 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X A134653 CA
Family Medicine Physician 207Q00000X A134653 CA Primary

Addresses

Primary practice location

300 Hillmont Ave
Ventura, CA 93003-1651

Mailing address

300 Hillmont Ave
Ventura, CA 93003-1651
Phone (805) 652-6228

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kaitlyn.ike@ventura.cernerdirect.com Direct

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
I20150810000958 CA Practitioner - Family Practice 1254645930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Georgia School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of VenturaGroup PAC ID 7911810171, 340 clinicians

Practice addresses (Care Compare)

300 Hillmont Ave
Ventura, CA 93003-1651

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.02 of 100Reported as group
Quality
64.51
Promoting interoperability
100
Improvement activities
40
Cost
72.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A134653CAMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
County of Ventura Current Accepting new patients
County of Ventura CurrentSince Jul 1, 2015 Accepting new patients
County of Ventura PastSince Jun 1, 2024 Accepting new patients

Locations

828 W Ventura St
Ste 100
Fillmore, CA 93015
Phone (805) 524-2000

825 N 10th St
Santa Paula, CA 93060
Phone (805) 933-8600

3291 Loma Vista Rd
Ventura, CA 93003
Phone (805) 652-6000

800 S Victoria Ave
#L4640
Ventura, CA 93009

133 W Santa Clara St
Ventura, CA 93001
Phone (805) 641-5600

300 Hillmont Ave
Ventura, CA 93003
Phone (805) 652-6000

Organizations & group practices 3

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1518302785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HILLMONT AVE",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031651",
            "telephone_number": "805-652-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HILLMONT AVE",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031651",
            "telephone_number": "805-652-6556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKE",
        "first_name": "KAITLYN",
        "middle_name": "REBECCA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-01",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "A134653",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A134653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kaitlyn.ike@ventura.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Cerner Direct Secure Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Information",
            "address_1": "300 Hillmont Ave",
            "city": "Ventura",
            "state": "CA",
            "country_code": "US",
            "postal_code": "930031651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.