NPIMap

Individual provider Active NPI

Kenneth W Westphal, MD

  • Specialist
  • Santa Cruz, CA
National Provider Identifier
1669545174
Registry record updated Nov 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G59273 Issued in CA
Practice address
1555 Soquel Avenue
Santa Cruz, CA 95065-1705
Phone
(831) 462-7700
Fax
(831) 462-7607
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G59273 CA Primary

Addresses

Primary practice location

1555 Soquel Avenue
Santa Cruz, CA 95065-1705

Mailing address

105A Cooper CT
Los Gatos, CA 95032-7604
Phone (408) 884-2710

Other identifiers 1

IdentifierTypeStateIssuer
G59273OtherCACA STATE LICENSE

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
I20090528000577 CA Practitioner - Pathology 2567511215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Loma Linda University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Pathology Medical Group IncGroup PAC ID 0143261214, 7 clinicians

Practice addresses (Care Compare)

1555 Soquel Dr
Santa Cruz, CA 95065-1705
Phone (408) 884-2712

Hospital & facility affiliations

  • Dominican Hospital Hospital, Santa Cruz, CA, CCN 050242
  • Watsonville Community Hospital Hospital, Watsonville, CA, CCN 050194
  • Stanford Health Care Hospital, Stanford, CA, CCN 050441

Merit-based Incentive Payment System (MIPS)

Final score
79.58 of 100Reported as group
Quality
59.16
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G59273CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Pathology Medical Group, Inc CurrentSince Mar 23, 2009 Accepting new patients
Associated Pathology Medical Group, Inc Specialist Current Accepting new patients
Associated Pathology Medical Group Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

105A Cooper Ct
Los Gatos, CA 95032
Phone (408) 884-2710

105 Cooper Ct
#A
Los Gatos, CA 95032

1555 Soquel Dr
Santa Cruz, CA 95065
Phone (831) 462-7700

75 Nielson St
Watsonville, CA 95076
Phone (831) 724-4741

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.

Hospital & facility affiliations 9

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194912000000",
    "number": "1669545174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105A COOPER CT",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950327604",
            "telephone_number": "408-884-2710",
            "fax_number": "408-884-2734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 SOQUEL AVENUE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651705",
            "telephone_number": "831-462-7700",
            "fax_number": "831-462-7607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTPHAL",
        "first_name": "KENNETH",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G59273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA STATE LICENSE",
            "identifier": "G59273",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.