Individual provider Active NPI

Keith Bradley Quattrocchi, MD, PHD, FACS

  • Neurological Surgery Physician
  • Davis, CA
National Provider Identifier
1730180910
Registry record updated Jan 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
G58571 Issued in CA
Practice address
140 B St
Suite 5
Davis, CA 95616-4653
Phone
(530) 401-0643
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X G58571 CA Primary

Addresses

Primary practice location

140 B St
Suite 5
Davis, CA 95616-4653

Mailing address

140 B St
Suite 5
Davis, CA 95616-4653
Phone (530) 401-0643

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
I20071013000111 CA Practitioner - NeurosurgeryPractitioner - Neurology 6709825904 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NeurosurgeryAlso: Neurology
Education
George Washington University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaweah Delta Health Care DistrictGroup PAC ID 6608778790, 110 clinicians

Practice addresses (Care Compare)

202 W Willow Ave
Suite 202
Visalia, CA 93291-6238
Phone (559) 624-6570

Hospital & facility affiliations

  • Kaweah Health Medical Center Hospital, Visalia, CA, CCN 050057

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G58571CAMDNeurological Surgery Physician
58571CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kaweah Delta Health Care District CurrentSince Jul 1, 2021 Accepting new patients
Center Neurorestoration Associates Inc., a Professional Corporation Neurological Surgery CurrentSince Dec 1, 2022 Accepting new patients
Kaweah Delta Health Care District Current Accepting new patients
Kaweah Delta Health Care District CurrentSince Jul 1, 2021 Accepting new patients
Nsi Consulting, Inc. Neurological Surgery PastSince Jan 18, 2012 Accepting new patients
University of California San Francisco Past Accepting new patients
University of North Carolina at Chapel Hill Past Accepting new patients
University of North Carolina Past Accepting new patients
Kaweah Delta Health Care District Past Accepting new patients

Locations

1000 N Mooney Blvd
Tulare, CA 93274
Phone (559) 624-6358

400 W Mineral King Ave
Visalia, CA 93291
Phone (559) 624-2001

202 W Willow Ave
Ste 202
Visalia, CA 93291
Phone (559) 334-0181

805 W Acequia Ave
Ste 2C
Visalia, CA 93291
Phone (559) 202-0282

840 S Akers St
Visalia, CA 93277
Phone (559) 624-3700

180 E Antelope Ave
Woodlake, CA 93286
Phone (559) 564-1800

Organizations & group practices 9

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 1

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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327449600000",
    "number": "1730180910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 B ST",
            "address_2": "SUITE 5",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956164653",
            "telephone_number": "530-401-0643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 B ST",
            "address_2": "SUITE 5",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956164653",
            "telephone_number": "530-401-0643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUATTROCCHI",
        "first_name": "KEITH",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "MD, PHD, FACS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2012-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "G58571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis, CA

Sources for this page

Verify at the official NPI Registry.