Individual provider Active NPI

Kassandra Walkowiak, D.C.

  • Chiropractor
  • Santa Monica, CA
National Provider Identifier
1609310119
Registry record updated Dec 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
33749 Issued in CA
Practice address
2428 Santa Monica Blvd Ste 308
Santa Monica, CA 90404-2046
Phone
(310) 453-8393
Fax
(310) 453-8696
NPI assigned
Dec 19, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 33749 CA Primary

Addresses

Primary practice location

2428 Santa Monica Blvd Ste 308
Santa Monica, CA 90404-2046

Mailing address

2428 Santa Monica Blvd Ste 308
Santa Monica, CA 90404-2046
Phone (310) 453-8393

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161223000099 CA Practitioner - Chiropractic 1557642964 Reassigns benefits to 1 organization
Practice locations: Camarillo, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

760 Las Posas Rd
Suite A3
Camarillo, CA 93010-2910
Phone (805) 482-0105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Health Atlast West la Chiropractor CurrentSince Jan 1, 2017 Accepting new patients
Optimal Chiropractic CurrentSince Jul 10, 2017 Accepting new patients
Health Atlast West la CurrentSince Jan 1, 2017 Accepting new patients
Health Atlast West la Inc Current Accepting new patients

Locations

760 Las Posas Rd
Ste A3
Camarillo, CA 93010
Phone (805) 454-7284

3030 Sawtelle Blvd
Los Angeles, CA 90066
Phone (310) 390-9018

2428 Santa Monica Blvd
Ste 308
Santa Monica, CA 90404
Phone (310) 453-8389

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1482105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1609310119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2428 SANTA MONICA BLVD STE 308",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042046",
            "telephone_number": "310-453-8393",
            "fax_number": "310-453-8696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2428 SANTA MONICA BLVD STE 308",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042046",
            "telephone_number": "310-453-8393",
            "fax_number": "310-453-8696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKOWIAK",
        "first_name": "KASSANDRA",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-19",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "33749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.