Individual provider Active NPI

Mark Kasow, M.D.

  • Family Medicine Physician
  • Thousand Oaks, CA
National Provider Identifier
1619946266
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A39116 Issued in CA
Practice address
620 E Janss Rd
Thousand Oaks, CA 91360-5113
Phone
(805) 495-6866
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A39116 CA Primary

Addresses

Primary practice location

620 E Janss Rd
Thousand Oaks, CA 91360-5113

Mailing address

1980 Orange Tree LN
Ste 103
Redlands, CA 92374-2803
Phone (909) 583-2741

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
I20090715000202 CA Practitioner - Family Practice 1456403997 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A39116CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Medical Group, Inc Family Medicine CurrentSince Dec 11, 2015 Accepting new patients
Desert Medical Group, Inc. Family Medicine CurrentSince Feb 23, 2019 Accepting new patients
Pinnacle Medical Group, Inc Family Medicine CurrentSince Dec 11, 2015 Accepting new patients
Hemet Valley Medical Center Past Accepting new patients
Compre Hensive Primary Care Medical Associates, Inc Family Medicine PastSince Feb 1, 2004 Accepting new patients
Cure4Feet Podiatry Group Inc PastSince Oct 15, 2013 Accepting new patients
Precision Occupational Medical Group, Inc. Past Accepting new patients
United Medical Care Center Inc. PastSince May 1, 2013 Accepting new patients
PRN Urgent Care, Inc. Urgent Care PastSince Mar 14, 2015 Accepting new patients

Locations

81880 Doctor Carreon Blvd
Ste C108
Indio, CA 92201
Phone (760) 775-9641

275 N El Cielo Rd
Palm Springs, CA 92262
Phone (760) 320-8814

10431 Lemon Ave
Ste N
Rch Cucamonga, CA 91737
Phone (909) 466-6579

1851 N Riverside Ave
Rialto, CA 92376
Phone (909) 421-2700

Organizations & group practices 9

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1619946266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1980 ORANGE TREE LN",
            "address_2": "STE 103",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923742803",
            "telephone_number": "909-583-2741",
            "fax_number": "909-793-2916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 E JANSS RD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913605113",
            "telephone_number": "805-495-6866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASOW",
        "first_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A39116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

Verify at the official NPI Registry.