Individual provider Active NPI

Kyle Matthew Griffith, MD

  • Student in an Organized Health Care Education/Training Program
  • Los Angeles, CA
National Provider Identifier
1740930254
Registry record updated Mar 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1975 Zonal Ave
Los Angeles, CA 90089-5601
Phone
(323) 442-1900
NPI assigned
Mar 27, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1975 Zonal Ave
Los Angeles, CA 90089-5601

Mailing address

300 N 130TH St Unit 2202
Seattle, WA 98133-7971
Phone (406) 253-4649

Other practice location 1

300 N 130th St Unit 2202
Seattle, WA 98133-7971
Phone (406) 253-4649

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
I20221205000134 CA Order and Referring Only - Orthopedic SurgeryPractitioner - Orthopedic Surgery 5193194744

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1648339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648339200000",
    "number": "1740930254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N 130TH ST UNIT 2202",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981337971",
            "telephone_number": "406-253-4649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 ZONAL AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900895601",
            "telephone_number": "323-442-1900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 N 130th St Unit 2202",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981337971",
            "country_code": "US",
            "telephone_number": "406-253-4649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIFFITH",
        "first_name": "KYLE",
        "middle_name": "MATTHEW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-27",
        "last_updated": "2022-03-27",
        "certification_date": "2022-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.