Active NPI
Judith E. Kraft, M.D.
- Family Medicine Physician
- Redondo Beach, CA
National Provider Identifier
1689732646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A65463
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A65463 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Venice Family Clinic | Current | Accepting new patients | |
| Venice Family Clinic | Current | 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
- 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.
-
- Federally Qualified Health Center (FQHC)
- Venice, CA
- NPI 1669418513
-
- Federally Qualified Health Center (FQHC)
- Hawthorne, CA
- NPI 1518739515
-
- Federally Qualified Health Center (FQHC)
- Gaithersburg, MD
- NPI 1699817775
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.