Organization Active NPI

Rupdev S. Khosa, M.D., Inc

  • Physical Medicine & Rehabilitation Physician
  • Arcadia, CA
National Provider Identifier
1730496480
Registry record updated Mar 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
A54411 Issued in CA
Legal business name
RUPDEV S. KHOSA, M.D., INC
Practice address
550 W Duarte Rd
#4
Arcadia, CA 91007-7331
Phone
(626) 445-7500
Fax
(626) 445-7555
NPI assigned
Sep 1, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2015

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

Authorized official

Name
Rupdev K. Khosa, M.D.
Title
President
Phone
(626) 445-7500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X A54411 CA Primary

Addresses

Primary practice location

550 W Duarte Rd
#4
Arcadia, CA 91007-7331

Mailing address

550 W Duarte Rd
#4
Arcadia, CA 91007-7331
Phone (626) 445-7500

Other identifiers 3

IdentifierTypeStateIssuer
A54411OtherCAMEDICARE - PALMETTO GBA
00A544110MedicaidCA
250011214OtherCARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100917000235 CA Part B Supplier - Clinic/Group Practice 8729103445 Receives reassigned benefits from 1 practitioner
Practice locations: Arcadia, CA

National Provider Directory

National Provider Directory

Locations

505 N Garfield Ave
Monterey Park, CA 91754

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426550400000",
    "number": "1730496480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 W DUARTE RD",
            "address_2": "#4",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910077331",
            "telephone_number": "626-445-7500",
            "fax_number": "626-445-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 W DUARTE RD",
            "address_2": "#4",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910077331",
            "telephone_number": "626-445-7500",
            "fax_number": "626-445-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUPDEV S. KHOSA, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-01",
        "last_updated": "2015-03-17",
        "status": "A",
        "authorized_official_last_name": "KHOSA",
        "authorized_official_first_name": "RUPDEV",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-445-7500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A54411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - PALMETTO GBA",
            "identifier": "A54411",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A544110",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "250011214",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.