Individual provider Active NPI

Poonam Kalkat, FNP

  • Nurse Practitioner
  • Pomona, CA
National Provider Identifier
1649818451
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95013051 Issued in CA
Practice address
1880 N Orange Grove Ave
Pomona, CA 91767-3006
Phone
(909) 620-7200
NPI assigned
Dec 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95013051 CA Primary

Addresses

Primary practice location

1880 N Orange Grove Ave
Pomona, CA 91767-3006

Mailing address

840 Towne Center Dr
Pomona, CA 91767-5900
Phone (909) 398-1550

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210824003486 CA Practitioner - Nurse Practitioner 5294130548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.52 of 100Reported as group
Quality
97.68
Improvement activities
40
Cost
62.65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Trauma Surgeons, Inc. CurrentSince May 22, 2021 Accepting new patients

Locations

47111 Monroe St
Indio, CA 92201
Phone (760) 347-6191

1050 Linden Ave
Long Beach, CA 90813
Phone (562) 491-9000

3630 E Imperial Hwy
Lynwood, CA 90262
Phone (310) 900-7420

380 E Paseo El Mirador
Palm Springs, CA 92262
Phone (760) 323-6316

Organizations & group practices 1

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": "1576108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1649818451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 TOWNE CENTER DR",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675900",
            "telephone_number": "909-398-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 N ORANGE GROVE AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673006",
            "telephone_number": "909-620-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALKAT",
        "first_name": "POONAM",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-12",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95013051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.