Elena F Kandel, M.D.
Individual provider Active NPI Dermatology Physician · N Hollywood, CA
NPI 1609871920 · NPPES record last updated Dec 14, 2017
Key facts
- NPI
- 1609871920
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- A78040 (CA)
- Practice address
- 12660 Riverside Dr
Ste 225
N Hollywood, CA 91607-3469 - Phone
- (818) 755-0265
- Fax
- (818) 753-9074
- NPI assigned
- Jun 14, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Dermatology
- Education
- University of California, Irvine, California College of Medicine, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lakeside Medical Organization a Medical Group Inc
Practice addresses (Care Compare)
12660 Riverside Dr
Suite 225
North Hollywood, CA 91607-3469
Phone (818) 755-0265
Merit-based Incentive Payment System (MIPS)
- Final score
- 80.57 of 100
- Quality
- 62.42
- Promoting interoperability
- 76
- Improvement activities
- 40
- Cost
- 76.15
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 51 |
| Removal of skin lesions | 834 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 131 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041104000925 | CA | Practitioner - Dermatology | 3173586765 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A78040 | CA | MD | Dermatology Physician |
Practice roles (6 of 7)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeside Medical Organization, a Medical Group Inc. | Dermatology | Current |
Accepting new patients |
| Lakeside Medical Associates, a Medical Group, Inc. | Past | Accepting new patients | |
| Lakeside Medical Associates, a Medical Group, Inc. | Dermatology | Past |
Accepting new patients |
| Lakeside Medical Associates, a Medical Group, Inc. | Past | Accepting new patients | |
| Lakeside Medical Associates, a Medical Group, Inc. | Dermatology | Past | Accepting new patients |
| Providence Health System - Southern California | Past | Accepting new patients |
Locations
191 S Buena Vista St
Ste 200
Burbank, CA 91505
Phone (818) 887-2671
14901 Rinaldi St
Ste 200201
Mission Hills, CA 91345
Phone (818) 365-8553
12660 Riverside Dr
Ste 225
North Hollywood, CA 91607
Phone (818) 487-0040
12660 Riverside Dr
Ste 310320
North Hollywood, CA 91607
Phone (818) 755-0391
8510 Balboa Blvd
Ste 150
Northridge, CA 91325
Phone (818) 637-2000
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- elena.kandel.p1@direct.lakeside.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | A78040 | CA | Yes |
Addresses
Primary practice location
12660 Riverside Dr
Ste 225
N Hollywood, CA 91607-3469
Mailing address
8510 Balboa Blvd
Ste 150
Northridge, CA 91325-5810
Phone (818) 637-2000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A780400 | Medicaid | CA |
Other providers in N Hollywood, CA
- Intersected Nutrition
- Gabriela A Irias
- Micah Jaffe
- Jaho Podiatry and Foot Group Apc
- Choong Il Jang
- Karo'S Medical Supply Inc.
- Angelina Marie Kashih
- Marina Khachatrian
- Khuri Foot & Ankle Podiatry Group Inc
- Oleg G Krutikov
All providers in N Hollywood, CA · Dermatology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 14, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.