NPIMap

Organization Active NPI

Kevin J. Pelton MD, Inc.

  • Orthopaedic Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1679771703
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
KEVIN J. PELTON MD, INC.
Practice address
1700 E Cesar E Chavez Ave
Suite 2200
Los Angeles, CA 90033-2424
Phone
(323) 264-7600
Fax
(323) 261-8027
NPI assigned
Jul 10, 2007
Last updated
May 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Authorized official

Name
Dr. Kevin Jeffrey Pelton, MDNPI 1033282637
Title
Director
Phone
(323) 264-7600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Orthopaedic Hand Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0106X
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X
Surgery of the Hand (Plastic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2082S0105X
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X

Addresses

Primary practice location

1700 E Cesar E Chavez Ave
Suite 2200
Los Angeles, CA 90033-2424

Mailing address

1700 E Cesar E Chavez Ave
Suite 2200
Los Angeles, CA 90033-2424
Phone (323) 264-7600

Other identifiers 1

IdentifierTypeStateIssuer
1033282637OtherCAIND NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080129000252 CA Part B Supplier - Clinic/Group Practice 3375625486 Receives reassigned benefits from 40 practitioners
Practice locations: Encino, CA; Thousand Oaks, CA; Tarzana, CA; Santa Fe Springs, CA; Los Angeles, CA; Glendale, CA; Santa Clarita, CA
O20221116000674 CA DME Supplier - Physician - Orthopedic/Orthopedic SurgeryDME Supplier - Physician - Podiatry 3375625486 Practice locations: Los Angeles, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

  • Kevin J. Pelton MD, Inc.

    dba Los Angeles Orthopaedic Surgery Specialists

    • Durable Medical Equipment & Medical Supplies
    • Santa Fe Springs, CA
    • NPI 1821711870

    3375625486

    Same PAC ID

National Provider Directory

National Provider Directory
Tax ID family
Kevin J Pelton MD Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

16530 Ventura Blvd
Encino, CA 91436
Phone (818) 789-4540

16530 Ventura Blvd
#V100
Encino, CA 91436

16530 Ventura Blvd
Ste 100
Encino, CA 91436
Phone (818) 317-8408

1700 E Cesar E Chavez Ave
Ste 22
Los Angeles, CA 90033

23502 Lyons Ave
Ste 202
Santa Clarita, CA 91321

Practitioners & affiliated clinicians

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 41

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1679771703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 E CESAR E CHAVEZ AVE",
            "address_2": "SUITE 2200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332424",
            "telephone_number": "323-264-7600",
            "fax_number": "323-261-8027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E CESAR E CHAVEZ AVE",
            "address_2": "SUITE 2200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332424",
            "telephone_number": "323-264-7600",
            "fax_number": "323-261-8027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN J. PELTON MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-10",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "PELTON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "JEFFREY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "323-264-7600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IND NPI",
            "identifier": "1033282637",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.