Individual provider Active NPI

Judith E. Kraft, M.D.

  • Family Medicine Physician
  • Redondo Beach, CA
National Provider Identifier
1689732646
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A65463 Issued in CA
Practice address
2114 Artesia Blvd
Redondo Beach, CA 90278-3014
Phone
(310) 392-8636
Fax
(310) 943-3521
NPI assigned
Dec 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A65463 CA Primary

Addresses

Primary practice location

2114 Artesia Blvd
Redondo Beach, CA 90278-3014

Mailing address

2114 Artesia Blvd
Redondo Beach, CA 90278-3014
Phone (310) 392-8636

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
I20100303000872 CA Practitioner - Family Practice 0547223562 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A65463CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Venice Family Clinic CurrentSince Apr 2, 2025 Accepting new patients
Venice Family Clinic CurrentSince Apr 2, 2025 Accepting new patients
Community Clinic, Inc. Past Accepting new patients

Locations

270 E 223rd St
Carson, CA 90745
Phone (310) 221-6800

2114 Artesia Blvd
Redondo Beach, CA 90278
Phone (310) 318-2521

604 Rose Ave
Venice, CA 90291
Phone (310) 392-8630

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jkraft753516@direct.ochin.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1689732646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 ARTESIA BLVD",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783014",
            "telephone_number": "310-392-8636",
            "fax_number": "310-943-3521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 ARTESIA BLVD",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783014",
            "telephone_number": "310-392-8636",
            "fax_number": "310-943-3521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAFT",
        "first_name": "JUDITH",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A65463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

Verify at the official NPI Registry.