Keivan Edalat, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A67803 Issued in CA

Practice address

1145 West Redondo Beach Blvd
Gardena, CA 90247

Phone

(310) 538-6629

NPI assigned

Jun 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Emergency Medicine

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Can Emergency Physicians Medical Group IncGroup PAC ID 8820304462, 49 clinicians

Gem Medical Group CorporationGroup PAC ID 3072984400, 54 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Huntington Beach Hospital Hospital, Huntington Beach, CA, CCN 050526
• Whittier Hospital Medical Center Hospital, Whittier, CA, CCN 050735

Merit-based Incentive Payment System (MIPS)

Final score

95.76 of 100Reported as group

Quality

83.25

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Can Emergency Physicians Medical Group, Inc.

  • Emergency Medicine Physician
  • Panorama City, CA
  • NPI 1265810006
  Medicare reassignment Care Compare group NPD
• Gem Medical Group Corporation

  • Emergency Medicine Physician
  • Whittier, CA
  • NPI 1689364721
  Medicare reassignment Care Compare group NPD
• Beach Emergency Medical Associates

  • Emergency Medicine Physician
  • Huntington Beach, CA
  • NPI 1013074996
  Medicare reassignment NPD
• Redondo Emergency Physicians, Inc.

  • Emergency Medicine Physician
  • Gardena, CA
  • NPI 1376834937
  Medicare reassignment NPD
• Can Emergency Physicians Medical Group Inc

  • Emergency Medicine Physician
  • Tustin, CA
  • NPI 1386018356
  NPD
• Gem Medical Group Corporation

  • Emergency Medicine Physician
  • Monterey Park, CA
  • NPI 1689386815
  NPD
• Anaheim Memorial Hospital Emergency Physicians Medical Group

  • Emergency Medicine Physician
  • Anaheim, CA
  • NPI 1801843917
  NPD (past)
• Emergency Physicians Medical Associates of Long Beach

  • Emergency Medicine Physician
  • Long Beach, CA
  • NPI 1386675015
  NPD (past)
• Gardena Emergency Medical Associates Inc

  • Emergency Medicine Physician
  • Gardena, CA
  • NPI 1497824189
  NPD (past)
• Medical Clinic of Mississippi

  • Family Medicine Physician
  • Jackson, MS
  • NPI 1912165523
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ahmc Whittier Hospital Medical

  • General Acute Care Hospital
  • Whittier, CA
  • NPI 1023000569
  Care Compare affiliation
• Prime Healthcare Huntington Beach, LLC

  • General Acute Care Hospital
  • Huntington Beach, CA
  • NPI 1083622120
  Care Compare affiliation

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1790727162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11260",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926851260",
            "telephone_number": "562-809-3542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 WEST REDONDO BEACH BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "90247",
            "telephone_number": "310-538-6629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDALAT",
        "first_name": "KEIVAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A67803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A678030",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kia Eaton
• Keith Andrew Kagahastian Ebilane, M.D.
• Athena Ebuen
• Karen Eckland
• Econo Pharmacy Inc
• Kimberly Jill Eddings-Reece, MD
• Edison Counseling Center
• Portia Edmonson
• Allison Nicole Trinidad Edquid, OTD, OTR
• Vincent Moses Gapuz Edralin Jr.

• Emergency Medicine Physician in Gardena, CA
• Providers in Gardena, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.