Individual provider Active NPI

Kean S. Ganan, D.O

  • Anesthesiology Physician
  • Carlsbad, CA
National Provider Identifier
1538174198
Registry record updated Aug 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
20A3146 Issued in CA
Practice address
655 Laguna Dr
Carlsbad, CA 92008-1610
Phone
(760) 729-7101
Fax
(760) 729-7106
NPI assigned
Jul 30, 2006
Last updated
Aug 5, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 20A3146 CA Primary

Addresses

Primary practice location

655 Laguna Dr
Carlsbad, CA 92008-1610

Mailing address

225 S Lake Ave
535
Pasadena, CA 91101-3005
Phone (626) 795-6596

Other identifiers 2

IdentifierTypeStateIssuer
020A31460OtherCABLUE SHIELD
020A31460MedicaidCA

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
I20100724000179 CA Practitioner - Anesthesiology 6901867522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Philadelphia College of Osteopathic Medicine, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

655 Laguna Dr
Carlsbad, CA 92008-1610
Phone (760) 729-7101

Merit-based Incentive Payment System (MIPS)

Final score
77.5 of 100Reported as individual
Quality
55
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A3146CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Snooz Inc Anesthesiology CurrentSince May 4, 2013 Accepting new patients

Locations

655 Laguna Dr
Carlsbad, CA 92008
Phone (619) 729-7101

25211 Paseo de Alicia
Ste 100
Laguna Hills, CA 92653
Phone (949) 900-3480

665 Camino de los Mares
Ste 103
San Clemente, CA 92673
Phone (949) 240-4978

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280966400000",
    "number": "1538174198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 S LAKE AVE",
            "address_2": "535",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911013005",
            "telephone_number": "626-795-6596",
            "fax_number": "626-795-8247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 LAGUNA DR",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081610",
            "telephone_number": "760-729-7101",
            "fax_number": "760-729-7106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANAN",
        "first_name": "KEAN",
        "middle_name": "S.",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2010-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "20A3146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "020A31460",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020A31460",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

Verify at the official NPI Registry.