Individual provider Active NPI

Ivanna Lynn Kenwood, DPM

  • Podiatrist
  • Santa Monica, CA
National Provider Identifier
1699329052
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5799 Issued in CA
Practice address
2001 Santa Monica Blvd Ste 1060
Santa Monica, CA 90404-2130
Phone
(310) 582-1940
NPI assigned
Jul 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X EL6932 CA
Podiatrist 213E00000X 5799 CA Primary

Addresses

Primary practice location

2001 Santa Monica Blvd Ste 1060
Santa Monica, CA 90404-2130

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

1720 E Cesar E Chavez Ave
Los Angeles, CA 90033-2414
Phone (323) 268-5000

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220720001377 CA Practitioner - Podiatry 6901287044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the University of CaliforniaGroup PAC ID 0547490534, 135 clinicians

Practice addresses (Care Compare)

100 UCLA Medical PLZ
Suite 460
Los Angeles, CA 90024-7000
Phone (310) 443-8999

757 Westwood PLZ
Los Angeles, CA 90095-0001
Phone (310) 825-9111

Hospital & facility affiliations

  • Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262
  • Santa Monica - UCLA Med Ctr & Orthopaedic Hospital Hospital, Santa Monica, CA, CCN 050112

Merit-based Incentive Payment System (MIPS)

Final score
81.42 of 100Reported as group
Quality
68.57
Promoting interoperability
100
Improvement activities
40
Cost
69.51

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue54
Removal of skin lesions1-10
Removal of nail tissue545
Removal or shaving of skin growth315

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5799CAMDPhysical Therapy Assistant
EL6932CAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Sep 1, 2022 Accepting new patients
Regents of the University of California CurrentSince Sep 1, 2022 Accepting new patients
Regents of the University of California Podiatrist Current Accepting new patients
UCLA Medical Group Past Accepting new patients

Locations

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

100 Medical Plz
Ste 460
Los Angeles, CA 90095
Phone (310) 825-6481

100 UCLA Medical Plz
Ste 460
Los Angeles, CA 90024
Phone (310) 443-8999

2001 Santa Monica Blvd
Ste 1060
Santa Monica, CA 90404
Phone (310) 582-1940

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1699329052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD STE 1060",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042130",
            "telephone_number": "310-582-1940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1720 E Cesar E Chavez Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900332414",
            "country_code": "US",
            "telephone_number": "323-268-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENWOOD",
        "first_name": "IVANNA",
        "middle_name": "LYNN",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-24",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "EL6932",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "5799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.