Individual provider Active NPI

Joseph Kamelgard, MD, FACS

  • Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1770549917
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
C147292 Issued in CA
Practice address
9100 Whitworth Dr Apt 4
Los Angeles, CA 90035-1333
Phone
(973) 573-2634
NPI assigned
Apr 25, 2006
Last updated
Jun 30, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25MA06782900 NJ
Surgery Physician 208600000X C147292 CA Primary

Addresses

Primary practice location

9100 Whitworth Dr Apt 4
Los Angeles, CA 90035-1333

Mailing address

9100 Whitworth Dr Apt 4
Los Angeles, CA 90035-1333
Phone (973) 573-2634

Other identifiers 1

IdentifierTypeStateIssuer
7771703MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C147292CAMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1770549917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 WHITWORTH DR APT 4",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351333",
            "telephone_number": "973-573-2634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 WHITWORTH DR APT 4",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351333",
            "telephone_number": "973-573-2634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMELGARD",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD, FACS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA06782900",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "C147292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7771703",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.