Kiran Gangadhar, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

A179353 Issued in CA

Practice address

2428 Santa Monica Blvd
Santa Monica, CA 90404-2045

Phone

(310) 315-1000

NPI assigned

Aug 14, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 6

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

Specialty

Diagnostic Radiology

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kern Radiology Medical Group IncGroup PAC ID 7214826460, 94 clinicians

Arizona Diagnostic Radiology Group LLCGroup PAC ID 1658796859, 62 clinicians

Desert Advanced Imaging Medical CenterGroup PAC ID 6406749613, 209 clinicians

Beverly Radiology Medical Group IIIGroup PAC ID 3476466376, 327 clinicians

Fresno Imaging CenterGroup PAC ID 2466553128, 127 clinicians

Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 48)

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.

• Beverly Radiology Medical Group III

  • Diagnostic Radiology Physician
  • Los Angeles, CA
  • NPI 1962457812
  Medicare reassignment Care Compare group NPD
• Desert Advanced Imaging Medical Center

  • Diagnostic Radiology Physician
  • Palm Desert, CA
  • NPI 1568416147
  Medicare reassignment Care Compare group NPD
• Fresno Imaging Center

  • Diagnostic Radiology Physician
  • Fresno, CA
  • NPI 1659456499
  Medicare reassignment Care Compare group NPD
• Kern Radiology Medical Group, Inc

  • Diagnostic Radiology Physician
  • Bakersfield, CA
  • NPI 1700821972
  Medicare reassignment Care Compare group NPD
• Cedars-Sinai Medical Care Foundation

  • Specialist
  • Los Angeles, CA
  • NPI 1316984388
  Medicare reassignment Care Compare group
• Arizona Diagnostic Radiology Group, LLC

  • Diagnostic Radiology Physician
  • Gilbert, AZ
  • NPI 1336757699

  CA

  Medicare reassignment Care Compare group
• Diagnostic Radiological Imaging

  • Diagnostic Radiology Physician
  • Sacramento, CA
  • NPI 1710931910
  Medicare reassignment NPD
• San Fernando Valley Interventional Radiology and Imaging Center

  • Vascular-Interventional Technology Radiologic Technologist
  • Encino, CA
  • NPI 1942350889
  Medicare reassignment NPD
• Innovative Radiology PA

  • Diagnostic Radiology Physician
  • Houston, TX
  • NPI 1568400810

  CA

  Medicare reassignment NPD
• Stockton Diagnostic Imaging

  • Diagnostic Radiology Physician
  • Stockton, CA
  • NPI 1356538201
  Medicare reassignment
• Beverly Radiology Medical Group

  • Diagnostic Radiology Physician
  • Van Nuys, CA
  • NPI 1164760823
  NPD
• Beverly Radiology Medical Group III

  • Diagnostic Radiology Physician
  • Victorville, CA
  • NPI 1114112372
  NPD

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

{
    "created_epoch": "1376438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1679906580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W",
            "address_2": "STE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364748",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2428 SANTA MONICA BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042045",
            "telephone_number": "310-315-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19020 33rd Ave W Ste 210",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980364748",
            "country_code": "US",
            "telephone_number": "425-563-1500 x1",
            "fax_number": "425-563-1501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11521 NE 128th St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Kirkland",
            "state": "WA",
            "postal_code": "980344317",
            "country_code": "US",
            "telephone_number": "425-952-6100",
            "fax_number": "425-952-6150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21700 Highway 99",
            "address_purpose": "LOCATION",
            "city": "Edmonds",
            "state": "WA",
            "postal_code": "980268034",
            "country_code": "US",
            "telephone_number": "425-640-4949",
            "fax_number": "425-640-4940",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1959 NE Pacific St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981950001",
            "country_code": "US",
            "telephone_number": "206-520-5700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANGADHAR",
        "first_name": "KIRAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-14",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "WA",
            "license": "MD60751368",
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "WA",
            "license": "MD60751368",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD60751368",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A179353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2036468",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI-EVERGREEN RADIA",
            "identifier": "0390732",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI-SWEDISH RADIA EDMONDS",
            "identifier": "0390731",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI-RADIA REST OF WA",
            "identifier": "0390729",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI-RADIA KING COUNTY",
            "identifier": "0390730",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679906580",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Diagnostic Radiology Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.