NPIMap

Individual provider Active NPI

Kevin D Kuettel, M.D.

  • Specialist
  • Anaheim, CA
National Provider Identifier
1740286384
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A44004 Issued in CA
Practice address
1211 W la Palma Ave
Ste 306
Anaheim, CA 92801-2811
Phone
(714) 778-1300
Fax
(714) 778-0303
NPI assigned
Jun 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A44004 CA Primary

Addresses

Primary practice location

1211 W la Palma Ave
Ste 306
Anaheim, CA 92801-2811

Mailing address

1211 W la Palma Ave
Ste 306
Anaheim, CA 92801-2811
Phone (714) 778-1300

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ82646ZMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120313000063 CA Practitioner - Gastroenterology 3072772938 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Gastroenterology Medical GroupGroup PAC ID 2365479565, 6 clinicians

Practice addresses (Care Compare)

1211 W la Palma Ave
Suite 306
Anaheim, CA 92801-2811
Phone (714) 778-1300

Hospital & facility affiliations

  • Foothill Regional Medical Center Hospital, Tustin, CA, CCN 050780
  • Ahmc Anaheim Regional Medical Center Hospital, Anaheim, CA, CCN 050226
  • Orange County Global Medical Center Hospital, Santa Ana, CA, CCN 050746
  • Chapman Global Medical Center Hospital, Orange, CA, CCN 050745
  • Coastal Communities Hospital Hospital, Santa Ana, CA, CCN 050747

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy52
Upper gastrointestinal (GI) endoscopy for acid reflux85

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44004CAMDDentist
A44004CAMDSpecialist

Practice roles (9 of 10)

OrganizationSpecialtyStatusNew patients
Associated Gastroenterology Medical Group Specialist CurrentSince Jan 14, 2002 Accepting new patients
Agmg Endoscopy Center a General Partnership CurrentSince Jan 14, 2002 Accepting new patients
Memorial Medical Group Inc Past Accepting new patients
St Jude Hospital Inc Past Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients
Alta Newport Hospital, LLC Past Accepting new patients
Chapman Medical Center Inc Past Accepting new patients
University of California Irvine Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients

Locations

1211 W La Palma Ave
Ste 301
Anaheim, CA 92801
Phone (714) 284-0737

1211 W La Palma Ave
Ste 306
Anaheim, CA 92801
Phone (714) 778-1300

2617 E Chapman Ave
Orange, CA 92869
Phone (714) 288-0052

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 5

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": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202774400000",
    "number": "1740286384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE",
            "address_2": "STE 306",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012811",
            "telephone_number": "714-778-1300",
            "fax_number": "714-778-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE",
            "address_2": "STE 306",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012811",
            "telephone_number": "714-778-1300",
            "fax_number": "714-778-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUETTEL",
        "first_name": "KEVIN",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2008-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A44004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ82646Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.