Individual provider Active NPI

Kearnan Adam Welch, D.O.

  • Endocrinology, Diabetes & Metabolism Physician
  • Monterey, CA
National Provider Identifier
1720463854
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
20A15114 Issued in CA
Practice address
2 Upper Ragsdale Dr BLDG a
Monterey, CA 93940-5736
Phone
(831) 333-3040
Fax
(831) 886-3639
NPI assigned
Jul 30, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 20A15114 CA Primary

Addresses

Primary practice location

2 Upper Ragsdale Dr BLDG a
Monterey, CA 93940-5736

Mailing address

2 Upper Ragsdale Dr BLDG a
Monterey, CA 93940-5736
Phone (831) 333-3040

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
I20200811004020 CA Practitioner - Endocrinology 6002164225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Montage Medical GroupGroup PAC ID 6406901941, 125 clinicians

Practice addresses (Care Compare)

2 Upper Ragsdale Dr
BLDG a
Monterey, CA 93940-5736
Phone (831) 718-9701

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.59 of 100Reported as group
Quality
81.82
Promoting interoperability
100
Improvement activities
40
Cost
73.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A15114CAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montage Medical Group CurrentSince Sep 1, 2020 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

23845 Holman Hwy
Ste 210
Monterey, CA 93940
Phone (831) 620-0296

2 Upper Ragsdale Dr
Bldg A
Monterey, CA 93940
Phone (831) 333-3040

100 Wilson Rd
Ste 100
Monterey, CA 93940
Phone (831) 242-8301

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.

Hospital & facility affiliations 3

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": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1720463854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 UPPER RAGSDALE DR BLDG A",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939405736",
            "telephone_number": "831-333-3040",
            "fax_number": "831-886-3639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 UPPER RAGSDALE DR BLDG A",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939405736",
            "telephone_number": "831-333-3040",
            "fax_number": "831-886-3639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCH",
        "first_name": "KEARNAN",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-30",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "20A15114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

Verify at the official NPI Registry.