Individual provider Active NPI

Ramesh C. Kesavalu, M.D.

  • Rheumatology Physician
  • Glendale, CA
National Provider Identifier
1932147626
Registry record updated Nov 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
A83127 Issued in CA
Practice address
222 W Eulalia St
Suite 200
Glendale, CA 91204-2849
Phone
(818) 291-4010
NPI assigned
Jun 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X A83127 CA Primary

Addresses

Primary practice location

222 W Eulalia St
Suite 200
Glendale, CA 91204-2849

Mailing address

1500S Central Ave 200
Glendale, CA 91204-3853
Phone (818) 291-4010

Other identifiers 1

IdentifierTypeStateIssuer
00A831270MedicaidCA

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
I20060826000015 CA Practitioner - Rheumatology 3577559954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeside Medical Organization a Medical Group IncGroup PAC ID 7618005166, 64 clinicians

Practice addresses (Care Compare)

1500 S Central Ave
Suite 200
Glendale, CA 91204-3853
Phone (818) 291-4010

Merit-based Incentive Payment System (MIPS)

Final score
80.57 of 100Reported as group
Quality
62.42
Promoting interoperability
76
Improvement activities
40
Cost
76.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
83127CAMDPharmacist
A83127CAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Medical Organization, a Medical Group Inc. Rheumatology CurrentSince Mar 17, 2010 Accepting new patients
Dignity Health Past Accepting new patients
Lakeside Medical Associates, a Medical Group, Inc. Past Accepting new patients
Lakeside Medical Associates, a Medical Group, Inc. Rheumatology Past Accepting new patients
Lakeside Medical Associates, a Medical Group, Inc. Rheumatology Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients

Locations

191 S Buena Vista St
Ste 200
Burbank, CA 91505
Phone (818) 887-2671

191 S Buena Vista St
Ste 400
Burbank, CA 91505
Phone (818) 818-0023

1500 S Central Ave
Ste 200
Glendale, CA 91204
Phone (818) 242-8916

222 W Eulalia St
Ste 200
Glendale, CA 91204
Phone (818) 291-4010

777 Flower St
Ste A
Glendale, CA 91201
Phone (818) 637-2000

8510 Balboa Blvd
Ste 150
Northridge, CA 91325
Phone (818) 637-2000

1500 W West Covina Pkwy
Ste 203
West Covina, CA 91790
Phone (626) 263-7030

1500 W West Covina Pkwy
West Covina, CA 91790
Phone (626) 430-9991

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ramesh.kesavalu.p1@direct.lakeside.nextgenshare.com

Organizations & group practices 7

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447113600000",
    "number": "1932147626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500S CENTRAL AVE 200",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912043853",
            "telephone_number": "818-291-4010",
            "fax_number": "818-291-4058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W EULALIA ST",
            "address_2": "SUITE 200",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042849",
            "telephone_number": "818-291-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESAVALU",
        "first_name": "RAMESH",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2015-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": "A83127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A831270",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.