NPIMap

Individual provider Active NPI

Kenneth Robert Daughters, M.D.

  • Diagnostic Radiology Physician
  • Santa Barbara, CA
National Provider Identifier
1598764193
Registry record updated Aug 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A74865 Issued in CA
Practice address
Peublo at Bath St.
Santa Barbara, CA 93105-4390
Phone
(805) 569-7279
Fax
(805) 569-8279
NPI assigned
Jul 18, 2005
Last updated
Aug 18, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A74865 CA Primary

Addresses

Primary practice location

Peublo at Bath St.
Santa Barbara, CA 93105-4390

Mailing address

PO Box 4219
Orange, CA 92863-4219
Phone (714) 571-5000

Other identifiers 4

IdentifierTypeStateIssuer
00A748650MedicaidCA
00A748650OtherBLUE SHIELD OF CA
P00275037OtherRAILROAD MEDICARE
050396CI06756OtherTRAILBLAZER

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
I20040701000692 CA Practitioner - Diagnostic Radiology 4183601768 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of California, Irvine, California College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Managed Imaging Medical Group IncGroup PAC ID 9436229887, 76 clinicians
Santa Barbara Radiology Medical Group, Inc.Group PAC ID 6800872953, 9 clinicians
Radia California Radiology Medical Group IncGroup PAC ID 8921465998, 134 clinicians
Radia Inc P SGroup PAC ID 9931012812, 275 clinicians

Practice addresses (Care Compare)

2309 Antonio Ave
Camarillo, CA 93010-1414
Phone (805) 389-5655

2410 Fletcher Ave
Santa Barbara, CA 93105-4828
Phone (805) 563-7000

351 S Patterson Ave
Santa Barbara, CA 93111-2403
Phone (805) 681-6406

400 W Pueblo St
Santa Barbara, CA 93105-4353
Phone (805) 569-7279

663 Del Parque
Unit D
Santa Barbara, CA 93103-5714
Phone (425) 563-1500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A74865CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radia Inc P S Diagnostic Radiology CurrentSince Jan 8, 2025 Accepting new patients
Sansum Clinic CurrentSince May 1, 2005 Accepting new patients
Sansum Clinic CurrentSince May 1, 2005 Accepting new patients
Radia California Radiology Medical Group Inc Diagnostic Radiology CurrentSince Jan 8, 2025 Accepting new patients
Sansum Clinic Current Accepting new patients
Santa Barbara Radiology Medical Group Inc Diagnostic Radiology CurrentSince Jul 1, 2005 Accepting new patients
Santa Barbara Cottage Hospital Past Accepting new patients
Sansum Clinic Past Accepting new patients
UCLA Radiology Medical Group Diagnostic Radiology Past Accepting new patients

Locations

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

400 W Pueblo St
Santa Barbara, CA 93105
Phone (805) 569-7279

215 Pesetas Ln
Santa Barbara, CA 93110
Phone (805) 681-1765

317 W Pueblo St
Santa Barbara, CA 93105
Phone (805) 681-7500

26357 McBean Pkwy
Ste 155
Santa Clarita, CA 91355
Phone (661) 288-5940

121 Sotoyome St
Fl 2
Santa Rosa, CA 95405

168 N Brent St
Ste 503
Ventura, CA 93003
Phone (805) 653-0101

Organizations & group practices 10

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 7

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219017600000",
    "number": "1598764193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4219",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928634219",
            "telephone_number": "714-571-5000",
            "fax_number": "714-571-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PEUBLO AT BATH ST.",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931054390",
            "telephone_number": "805-569-7279",
            "fax_number": "805-569-8279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHTERS",
        "first_name": "KENNETH",
        "middle_name": "ROBERT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2008-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A74865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A748650",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "00A748650",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00275037",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAILBLAZER",
            "identifier": "050396CI06756",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.