NPIMap

Individual provider Active NPI

Aditya Sanjeev Kuwadekar, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Fullerton, CA
National Provider Identifier
1790139285
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
25MA11535800 Issued in NJ
Practice address
101 E Valencia Mesa Dr
Fullerton, CA 92835-3809
Phone
(714) 446-7505
NPI assigned
Apr 20, 2016
Last updated
Dec 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 25MA11535800 NJ Primary

Addresses

Primary practice location

101 E Valencia Mesa Dr
Fullerton, CA 92835-3809

Mailing address

PO Box 749241
Los Angeles, CA 90074-9241
Phone (314) 849-3535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220816002466 NJ Practitioner - Pathology 3072996560 Reassigns benefits to 1 organization
I20231213002949 CA Practitioner - Pathology 3072996560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Pathology Group IncGroup PAC ID 5698839637, 6 clinicians

Practice addresses (Care Compare)

101 E Valencia Mesa Dr
Fullerton, CA 92835-3809
Phone (714) 446-7505

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.85 of 100Reported as group
Quality
68.07
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
76.06 of 100Reported as group
Quality
62.57
Improvement activities
40
Cost
70.1

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Livingston Pathology Associates, LLC Anatomic Pathology & Clinical Pathology CurrentSince Aug 1, 2022 Accepting new patients
The Pathology Group, Inc. Anatomic Pathology & Clinical Pathology CurrentSince Jan 1, 2024 Accepting new patients
St Jude Hospital Inc Past Accepting new patients

Locations

101 E Valencia Mesa Dr
Fullerton, CA 92835
Phone (714) 446-7505

1919 S Highland Ave
Ste 210
Lombard, IL 60148

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1790139285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749241",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900749241",
            "telephone_number": "314-849-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E VALENCIA MESA DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353809",
            "telephone_number": "714-446-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUWADEKAR",
        "first_name": "ADITYA",
        "middle_name": "SANJEEV",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-20",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NJ",
            "license": "25MA11535800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.