NPIMap

Individual provider Active NPI

Farough Kerendi, M.D.

  • General Practice Physician
  • Los Angeles, CA
National Provider Identifier
1568538593
Registry record updated Nov 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A40018 Issued in CA
Practice address
6360 Wilshire Blvd
Suite 414
Los Angeles, CA 90048-5603
Phone
(323) 655-1930
Fax
(323) 655-1377
NPI assigned
Nov 28, 2006
Last updated
Nov 14, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A40018 CA Primary

Addresses

Primary practice location

6360 Wilshire Blvd
Suite 414
Los Angeles, CA 90048-5603

Mailing address

6360 Wilshire Blvd
Suite 414
Los Angeles, CA 90048-5603
Phone (323) 655-1930

Other identifiers 1

IdentifierTypeStateIssuer
00A400181MedicaidCA

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
I20080529000343 CA Practitioner - General Practice 7810076437 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1961
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Farough Kerendi MD IncGroup PAC ID 0143390450, 2 clinicians

Practice addresses (Care Compare)

6360 Wilshire Blvd
Suite 414
Los Angeles, CA 90048-5606
Phone (323) 655-1930

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A40018CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Farough Kerendi MD Inc General Practice CurrentSince Jan 1, 2007 Accepting new patients

Locations

6360 Wilshire Blvd
Ste 414
Los Angeles, CA 90048
Phone (323) 397-0897

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Alvarado Care CenterLos Angeles, CA, CCN 056157 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 9, 1999
Feb 9, 1999

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 9

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321228800000",
    "number": "1568538593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6360 WILSHIRE BLVD",
            "address_2": "SUITE 414",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485603",
            "telephone_number": "323-655-1930",
            "fax_number": "323-655-1377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6360 WILSHIRE BLVD",
            "address_2": "SUITE 414",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485603",
            "telephone_number": "323-655-1930",
            "fax_number": "323-655-1377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERENDI",
        "first_name": "FAROUGH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2011-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A40018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A400181",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.