Individual provider Active NPI

Kushi Mehrotra, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Torrance, CA
National Provider Identifier
1679627889
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
A67348 Issued in CA
Practice address
22617 S Vermont Ave
Torrance, CA 90502-2550
Phone
(310) 320-4130
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X A67348 CA Primary

Addresses

Primary practice location

22617 S Vermont Ave
Torrance, CA 90502-2550

Mailing address

2728 Ralston LN
Redondo Beach, CA 90278-4617
Phone (310) 921-3634

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20121113000705 WA Practitioner - Geriatric MedicinePractitioner - Internal Medicine 3173511672 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington Pac Services PCGroup PAC ID 4082986070, 43 clinicians

Practice addresses (Care Compare)

127 2ND Ave SW
Soap Lake, WA 98851-9126
Phone (509) 246-1111

Hospital & facility affiliations

  • Columbia Basin Hospital Hospital, Ephrata, WA, CCN 501317
  • McKay Healthcare & Rehab Ctr Nursing home, Soap Lake, WA, CCN 505390

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wa Pacs 2 PC CurrentSince Jun 1, 2021 Accepting new patients
Washington Pac Services PC CurrentSince Jun 1, 2021 Accepting new patients
CS Pacs 3 Northwest, LLC CurrentSince Sep 28, 2024 Accepting new patients
Public Hospital District #4 of Grant County Past Accepting new patients

Locations

414 17th St SE
Auburn, WA 98002
Phone (253) 320-0748

21008 76th Ave W
Edmonds, WA 98026
Phone (425) 778-0107

135 S 336th St
Federal Way, WA 98003
Phone (253) 835-7433

920 12th Ave SE
Puyallup, WA 98372
Phone (253) 841-3422

3600 E Hartson Ave
Spokane, WA 99202
Phone (509) 468-7000

414 S University Rd
Spokane Valley, WA 99206
Phone (509) 924-4650

14820 E 4th Ave
Spokane Valley, WA 99216
Phone (509) 922-1644

Interoperability endpoints

  • Direct secure messaging: kmehrotra4024929@wm.providencedirect.org

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 2

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": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679627889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2728 RALSTON LN",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902784617",
            "telephone_number": "310-921-3634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22617 S VERMONT AVE",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022550",
            "telephone_number": "310-320-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHROTRA",
        "first_name": "KUSHI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A67348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.