Donald Kettyls, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A173802 Issued in CA

Practice address

311 W I St
Los Banos, CA 93635-3479

Phone

(209) 826-2222

NPI assigned

Jul 5, 2018

Last updated

Aug 4, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Karthikeya Devireddy MD Inc

  dba apex medical group inc

  • Rural Health Clinic/Center
  • Los Banos, CA
  • NPI 1518089507

  Single Specialty

  Medicare reassignment NPD
• KD Medical Group Inc

  dba Padres Medical Imaging,Inc.

  • Family Medicine Physician
  • Los Banos, CA
  • NPI 1457522567

  Single Specialty

  Medicare reassignment NPD
• KD Medical Group Inc

  dba Foot & Ankle Podiatric & Orthopedic Care

  • Podiatrist
  • Los Banos, CA
  • NPI 1306372198

  Single Specialty

  NPD

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

{
    "created_epoch": "1530748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1851887558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W I ST",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936353479",
            "telephone_number": "209-826-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W I ST",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936353479",
            "telephone_number": "209-826-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETTYLS",
        "first_name": "DONALD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-05",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A173802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Simranpreet Kaur
• KD Medical Group Inc (Foot & Ankle Podiatric & Orthopedic Care)
• KD Medical Group Inc (Padres Medical Imaging,Inc.)
• Thomas Vernon Keller, D.C
• Savuth Kem, PA C
• Zeenat Khan, BDS, MS
• Santosh Khanal, MBBS
• Daniel Koh, CHW
• Mukhtar Kohistani, FNP-C
• Pratap S Kurra, MD

• Family Medicine Physician in Los Banos, CA
• Providers in Los Banos, 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 Aug 4, 2021; 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.