Kenneth W Chin, MD

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

G29660 Issued in CA

Practice address

18133 Ventura Blvd Ste 100
Tarzana, CA 91356-3641

Phone

(818) 933-2020

Fax

(818) 817-7668

NPI assigned

Nov 17, 2005

Last updated

Nov 17, 2023By 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 2

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

Diagnostic Radiology

Education

Harvard Medical School, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beverly Radiology Medical Group IIIGroup PAC ID 3476466376, 327 clinicians

Desert Advanced Imaging Medical CenterGroup PAC ID 6406749613, 209 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

91.25 of 100Reported as group

Quality

75

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

91.25 of 100Reported as group

Quality

75

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 42)

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.

• Beverly Radiology Medical Group III

  • Diagnostic Radiology Physician
  • Los Angeles, CA
  • NPI 1962457812
  Medicare reassignment Care Compare group NPD
• Desert Advanced Imaging Medical Center

  • Diagnostic Radiology Physician
  • Palm Desert, CA
  • NPI 1568416147
  Medicare reassignment Care Compare group NPD
• Diagnostic Radiological Imaging

  • Diagnostic Radiology Physician
  • Sacramento, CA
  • NPI 1710931910
  Medicare reassignment NPD
• Fresno Imaging Center

  • Diagnostic Radiology Physician
  • Fresno, CA
  • NPI 1659456499
  Medicare reassignment NPD
• Modesto Advanced Diagnostic Imaging Medical Center

  dba Modesto Advanced Diag Imaging Medical Center

  • Diagnostic Radiology Physician
  • Modesto, CA
  • NPI 1730133893
  Medicare reassignment NPD
• Norcal Imaging

  • Diagnostic Radiology Physician
  • Concord, CA
  • NPI 1003965997
  Medicare reassignment NPD
• Pronet Imaging Medical Group, Inc.

  • Diagnostic Radiology Physician
  • Los Angeles, CA
  • NPI 1528099488
  Medicare reassignment NPD
• Radnet Medical Imaging-San Francisco

  • Diagnostic Radiology Physician
  • San Francisco, CA
  • NPI 1548345382
  Medicare reassignment NPD
• San Fernando Valley Interventional Radiology and Imaging Center

  • Vascular-Interventional Technology Radiologic Technologist
  • Encino, CA
  • NPI 1942350889
  Medicare reassignment NPD
• Santa Rosa Imaging Medical Center

  • Diagnostic Radiology Physician
  • Santa Rosa, CA
  • NPI 1689890444
  Medicare reassignment NPD
• Stockton Diagnostic Imaging

  • Diagnostic Radiology Physician
  • Stockton, CA
  • NPI 1356538201
  Medicare reassignment NPD
• Kenneth W. Chin, M.D., Incorporated

  • Vascular & Interventional Radiology Physician
  • Encino, CA
  • NPI 1073522314
  NPD (past) Authorized official

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1902888704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18133 VENTURA BLVD STE 100",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563641",
            "telephone_number": "818-933-2020",
            "fax_number": "818-817-7668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18133 VENTURA BLVD STE 100",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563641",
            "telephone_number": "818-933-2020",
            "fax_number": "818-817-7668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIN",
        "first_name": "KENNETH",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G29660",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "G29660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G296600",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lawrence W. Chespak, M.D.
• Richard Yin Chew, D.D.S.
• Hiuming Esther Chick, NP
• Dana Chidekel, PH.DL
• Vardui Chilingaryan, MA, BCBA
• Kimberly Briyitt Chinchilla, MS CF-SLP
• Jerren Chiu
• Hyo-Jung Choi, MBBS
• Priyanka Chopra
• George Chow, MD

• Vascular & Interventional Radiology Physician in Tarzana, CA
• Providers in Tarzana, CA by specialty
• Vascular & Interventional Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.
• 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.