Biju Joseph Kallumkal, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11531 Issued in CA

Practice address

2059 Hillman St
Tulare, CA 93274-1609

Phone

(559) 605-0090

NPI assigned

Oct 28, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• The Medina Clinic, Incorporated

  • Primary Care Clinic/Center
  • Grandview, MO
  • NPI 1073893046
  NPD (past)

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

{
    "created_epoch": "1666915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1821705047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2059 HILLMAN ST",
            "city": "TULARE",
            "state": "CA",
            "postal_code": "932741609",
            "telephone_number": "818-648-9469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2059 HILLMAN ST",
            "city": "TULARE",
            "state": "CA",
            "postal_code": "932741609",
            "telephone_number": "559-605-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLUMKAL",
        "first_name": "BIJU",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-28",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "11531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shruti Roy Joseph, M.D.
• Rodrigo Juarez
• K David Flora DPM Inc
• Phillip Bernays Kaestner
• Gurjeet Rita Kaila, O.D.
• Pradeep Kumar Kamboj, M.D.
• Prem K. Kamboj, M.D.
• Sofya Kats, DO
• Donavan Kaundart
• Maninder Kaur, MD

• Family Medicine Physician in Tulare, CA
• Providers in Tulare, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.