Individual provider Active NPI

Kenneth Rich, MD

  • Emergency Medicine Physician
  • Santa Ana, CA
National Provider Identifier
1801816004
Registry record updated May 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A50272 Issued in CA
Practice address
1401 N Tustin Ave
Ste 130
Santa Ana, CA 92705-8644
Phone
(714) 542-3008
Fax
(714) 542-3617
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A50272 CA Primary

Addresses

Primary practice location

1401 N Tustin Ave
Ste 130
Santa Ana, CA 92705-8644

Mailing address

506 16TH St
Huntington Beach, CA 92648-4014
Phone (714) 374-9111

Other identifiers 2

IdentifierTypeStateIssuer
930128601OtherCARAILROAD MEDICARE
00A502720MedicaidCA

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
A50272CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Continuum Medical Associates,a Professional Medical Corporation Emergency Medicine Past Accepting new patients
Maged a. Tanios, MD, Inc Past Accepting new patients
Jse Emergency Medical Group Emergency Medicine Past Accepting new patients
Southern California Pulmonologists and Intensivists Network Past Accepting new patients
Gap Medical Equipment Inc. Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463616000000",
    "number": "1801816004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 16TH ST",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926484014",
            "telephone_number": "714-374-9111",
            "fax_number": "714-374-7311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 N TUSTIN AVE",
            "address_2": "STE 130",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927058644",
            "telephone_number": "714-542-3008",
            "fax_number": "714-542-3617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICH",
        "first_name": "KENNETH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2016-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A50272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "930128601",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A502720",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; 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.