Individual provider Active NPI

Rajiv Kumar, M.D.

  • Psychiatry Physician
  • Agoura Hills, CA
National Provider Identifier
1689681173
Registry record updated Dec 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
C50669 Issued in CA
Practice address
30423 Canwood St Ste 118
Agoura Hills, CA 91301-4314
Phone
(818) 707-2130
Fax
(818) 707-2131
NPI assigned
Aug 1, 2006
Last updated
Dec 30, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X C50669 CA Primary

Addresses

Primary practice location

30423 Canwood St Ste 118
Agoura Hills, CA 91301-4314

Mailing address

30423 Canwood St Ste 140
Agoura Hills, CA 91301-4315
Phone (818) 707-2130

Other identifiers 1

IdentifierTypeStateIssuer
00C506690MedicaidCA

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
I20120507000614 CA Practitioner - Psychiatry 2365604436 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

30423 Canwood St
Suite 140
Agoura Hills, CA 91301-4315
Phone (818) 707-2130

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C50669CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Services Incorporated Psychiatry CurrentSince Oct 1, 2015 Accepting new patients
Rajiv Kumar MD Inc Psychiatry CurrentSince Nov 29, 2011 Accepting new patients

Locations

29800 Agoura Rd
Ste 200
Agoura Hills, CA 91301
Phone (818) 706-9300

30423 Canwood St
Ste 118
Agoura Hills, CA 91301
Phone (425) 802-2861

30423 Canwood St
Ste 140
Agoura Hills, CA 91301
Phone (818) 707-2130

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325203200000",
    "number": "1689681173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30423 CANWOOD ST STE 140",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913014315",
            "telephone_number": "818-707-2130",
            "fax_number": "818-707-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30423 CANWOOD ST STE 118",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913014314",
            "telephone_number": "818-707-2130",
            "fax_number": "818-707-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "RAJIV",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2011-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C50669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C506690",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Agoura Hills, CA

Sources for this page

Verify at the official NPI Registry.