Individual provider Active NPI

Kevin Thien Toan Bui, M.D.

  • Vascular & Interventional Radiology Physician
  • La Mesa, CA
National Provider Identifier
1578906186
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
A134576 Issued in CA
Practice address
5555 Grossmont Center Dr
La Mesa, CA 91942-3019
Phone
(619) 740-5100
NPI assigned
Apr 12, 2013
Last updated
Jul 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X A134576 CA Primary

Addresses

Primary practice location

5555 Grossmont Center Dr
La Mesa, CA 91942-3019

Mailing address

7777 Alvarado Rd Ste 108
La Mesa, CA 91942-8245
Phone (619) 460-2770

Other practice location 1

200 W Arbor Dr # 8756
San Diego, CA 92103
Phone (619) 543-3534

Other practice location 2

200 W Arbor Dr # 8756
San Diego, CA 92103
Phone (619) 543-3534

Other practice location 3

101 The City Dr S
Bldg. 1 #0115 Rt.140
Orange, CA 92868-3201
Phone (714) 456-6579

Other practice location 4

5528 E La Palma Ave Ste 4A
Anaheim, CA 92807
Phone (714) 970-0200

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
I20190715002488 CA Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 6507174448 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Saint Louis University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
X-Ray Medical Group IncGroup PAC ID 5294796801, 44 clinicians

Practice addresses (Care Compare)

5555 Grossmont Ctr Dr
La Mesa, CA 91942-3019
Phone (619) 740-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A134576CAMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Ucsd Department of Radiology CurrentSince May 10, 2021 Accepting new patients
Regents of the University of California Vascular & Interventional Radiology CurrentSince May 10, 2021 Accepting new patients
X-Ray Medical Group Inc CurrentSince Jun 1, 2022 Accepting new patients
United Premier Physicians Inc CurrentSince Feb 24, 2022 Accepting new patients
C J Calvin Yang, M D a Professional Corp CurrentSince Feb 24, 2022 Accepting new patients

Locations

235 S Garfield Ave
Alhambra, CA 91801
Phone (626) 943-9985

320 S Garfield Ave
Ste 102
Alhambra, CA 91801
Phone (626) 281-0124

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

7777 Alvarado Rd
Ste 108
La Mesa, CA 91942
Phone 6194602770 ext. 303

312 N Garfield Ave
Monterey Park, CA 91754
Phone (626) 572-2889

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

200 W Arbor Dr
#8756
San Diego, CA 92103
Phone (619) 543-3534

8929 University Center Ln
Ste 101
San Diego, CA 92122
Phone (858) 457-4227

10 Little Brook Rd
West Wareham, MA 02576

Organizations & group practices 6

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 5

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": "1365724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1578906186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 ALVARADO RD STE 108",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919428245",
            "telephone_number": "619-460-2770",
            "fax_number": "619-460-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 GROSSMONT CENTER DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423019",
            "telephone_number": "619-740-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W Arbor Dr # 8756",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "92103",
            "country_code": "US",
            "telephone_number": "619-543-3534",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 W Arbor Dr # 8756",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "92103",
            "country_code": "US",
            "telephone_number": "619-543-3534",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 The City Dr S",
            "address_2": "Bldg. 1 #0115 Rt.140",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928683201",
            "country_code": "US",
            "telephone_number": "714-456-6579",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5528 E La Palma Ave Ste 4A",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "92807",
            "country_code": "US",
            "telephone_number": "714-970-0200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUI",
        "first_name": "KEVIN",
        "middle_name": "THIEN TOAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-12",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "A134576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.