Individual provider Active NPI

Andre Martin Kasko, D.O.

  • Gynecology Physician
  • Yucca Valley, CA
National Provider Identifier
1679624191
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
20A6300 Issued in CA
Practice address
57445 29 Palms Hwy
Suite 301
Yucca Valley, CA 92284-2947
Phone
(760) 365-2800
Fax
(760) 365-1406
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X 20A6300 CA
Gynecology Physician 207VG0400X 20A6300 CA Primary

Addresses

Primary practice location

57445 29 Palms Hwy
Suite 301
Yucca Valley, CA 92284-2947

Mailing address

PO Box 1220
Joshua Tree, CA 92252-0810
Phone (760) 365-2800

Other identifiers 3

IdentifierTypeStateIssuer
00AX63000MedicaidCA
207V00000XMedicaidCA
207VG0400XMedicaidCA

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
I20050111000463 CA Practitioner - Obstetrics/GynecologyPractitioner - Family Practice 7012826324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/GynecologyAlso: Family Practice
Education
College of Osteo Med of the Pacific at Pomona, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Health Center of Joshua Tree, IncGroup PAC ID 0648346007, shared by 2 NPIs, 2 clinicians
Morongo Basin OB/GYN Medical Group IncGroup PAC ID 7416905914, 2 clinicians

Practice addresses (Care Compare)

57445 29 Palms Hwy
Suite 302
Yucca Valley, CA 92284-2947
Phone (760) 366-7555

63532 20 Palms Hwy
Joshua Tree, CA 92252
Phone (760) 366-1800

Hospital & facility affiliations

  • Suncrest Healthcare Home health agency, Palm Desert, CA, CCN 757159
  • Hi-Desert Medical Center Hospital, Joshua Tree, CA, CCN 050279
  • Desert Regional Medical Center Hospital, Palm Springs, CA, CCN 050243

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A6300CAMDObstetrics Physician
6300CAMDSpeech-Language Assistant

Practice roles (5 of 6)

OrganizationSpecialtyStatusNew patients
Morongo Basin OB/GYN Medical Group Inc Critical Care Medicine CurrentSince Feb 1, 2003 Accepting new patients
Morongo Basin OB/GYN Medical Group Inc Gynecology Current Accepting new patients
Coachella Desert Oasis OB/GYN, Medical Associates Inc. Past Accepting new patients
Family Health Center of Joshua Tree, Inc. PastSince Jun 5, 2007 Accepting new patients
High Desert Family Medical Clinic Past Accepting new patients

Locations

57445 29 Palms Hwy
Ste 301
Yucca Valley, CA 92284
Phone (760) 365-2800

7350 Church St
Yucca Valley, CA 92284
Phone (760) 369-3069

57445 29 Palms Hwy
Ste 302
Yucca Valley, CA 92284
Phone (760) 366-7555

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Family Health Center of Joshua Tree, IncYucca Valley, CA, CCN 058941 Rural health clinic 5% Or Greater Direct Ownership Interest
W-2 Managing Employee
Sep 8, 2008
Sep 8, 2008
Hi-Desert Medical ClinicYucca Valley, CA, CCN 553845 Rural health clinic 5% Or Greater Direct Ownership Interest
W-2 Managing Employee
Sep 2, 2009
Sep 2, 2009

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 3

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1679624191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1220",
            "city": "JOSHUA TREE",
            "state": "CA",
            "postal_code": "922520810",
            "telephone_number": "760-365-2800",
            "fax_number": "760-365-1406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57445 29 PALMS HWY",
            "address_2": "SUITE 301",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922842947",
            "telephone_number": "760-365-2800",
            "fax_number": "760-365-1406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASKO",
        "first_name": "ANDRE",
        "middle_name": "MARTIN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "CA",
            "license": "20A6300",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": "20A6300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX63000",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207V00000X",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207VG0400X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yucca Valley, CA

Sources for this page

Verify at the official NPI Registry.