Individual provider Active NPI

Keri Reese Zickuhr, M.D.

  • Orthopaedic Surgery Physician
  • Torrance, CA
National Provider Identifier
1891993762
Registry record updated Aug 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
A88233 Issued in CA
Practice address
23560 Crenshaw Blvd Ste 102
Torrance, CA 90505-5233
Phone
(310) 784-2355
Fax
(310) 517-1817
NPI assigned
Jul 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X A88233 CA Primary

Addresses

Primary practice location

23560 Crenshaw Blvd Ste 102
Torrance, CA 90505-5233

Mailing address

23560 Crenshaw Blvd Ste 102
Torrance, CA 90505-5233
Phone (310) 784-2355

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080516000145 CA Practitioner - Orthopedic Surgery 6709955784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Torrance Health Association IncGroup PAC ID 1355302134, 298 clinicians

Practice addresses (Care Compare)

23550 Hawthorne Blvd
Suite 120
Torrance, CA 90505-4767
Phone (310) 517-1216

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A88233CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Torrance Health Association Inc CurrentSince Apr 1, 2017 Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients

Locations

705 Pier Ave
Ste B
Hermosa Beach, CA 90254
Phone (310) 257-7298

705 Pier Ave
#B
Hermosa Beach, CA 90254
Phone (310) 784-2355

514 N Prospect Ave
Fl 4
Redondo Beach, CA 90277
Phone (310) 750-3300

23326 Hawthorne Blvd
Ste 200
Torrance, CA 90505
Phone (310) 257-7205

23560 Crenshaw Blvd
Ste 102
Torrance, CA 90505
Phone (310) 784-2355

23550 Hawthorne Blvd
Ste 120
Torrance, CA 90505
Phone (310) 517-1216

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345507200000",
    "number": "1891993762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23560 CRENSHAW BLVD STE 102",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055233",
            "telephone_number": "310-784-2355",
            "fax_number": "310-517-1817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23560 CRENSHAW BLVD STE 102",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055233",
            "telephone_number": "310-784-2355",
            "fax_number": "310-517-1817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZICKUHR",
        "first_name": "KERI",
        "middle_name": "REESE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2012-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A88233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.