Individual provider Active NPI

Kenneth L Croutch, MD

  • Diagnostic Radiology Physician
  • Los Angeles, CA
National Provider Identifier
1982731311
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G71093 Issued in CA
Practice address
8700 Beverly Blvd
Room M335
Los Angeles, CA 90048
Phone
(310) 423-8000
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G71093 CA Primary

Addresses

Primary practice location

8700 Beverly Blvd
Room M335
Los Angeles, CA 90048

Mailing address

PO Box 4313
Woodland Hills, CA 91365-4313
Phone (805) 375-8800

Other identifiers 1

IdentifierTypeStateIssuer
00G710930MedicaidCA

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
I20110128000255 CA Practitioner - Diagnostic Radiology 2668550633 Reassigns benefits to 15 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Southern California Keck School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10101 Riverside Dr
Toluca Lake, CA 91602-2517
Phone (818) 762-2626

18523 Corwin Rd
Suite J
Apple Valley, CA 92307-2300
Phone (760) 242-4444

Merit-based Incentive Payment System (MIPS)

Final score
91.25 of 100Reported as group
Quality
75
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71093CAMDPharmacist
G71093CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pronet Imaging Medical Group, Inc. Diagnostic Radiology CurrentSince Dec 4, 2017 Accepting new patients
Innovative Radiology PA Diagnostic Radiology CurrentSince Aug 5, 2024 Accepting new patients
Arizona Diagnostic Radiology Group, LLC Diagnostic Radiology CurrentSince Aug 15, 2020 Accepting new patients
Fresno Imaging Center Diagnostic Radiology CurrentSince Mar 7, 2017 Accepting new patients
Diagnostic Radiological Imaging Diagnostic Radiology CurrentSince Dec 1, 2017 Accepting new patients
Desert Advanced Imaging Medical Center Diagnostic Radiology CurrentSince Apr 9, 2017 Accepting new patients
Stockton Diagnostic Imaging Diagnostic Radiology CurrentSince Dec 1, 2017 Accepting new patients
San Fernando Valley Interventional Radiology and Imaging Center CurrentSince Jan 1, 2016 Accepting new patients
Santa Rosa Imaging Medical Center Diagnostic Radiology CurrentSince Dec 1, 2017 Accepting new patients
Norcal Imaging Diagnostic Radiology CurrentSince Jan 23, 2018 Accepting new patients
Beverly Radiology Medical Group III Diagnostic Radiology CurrentSince Jan 1, 2014 Accepting new patients
Radnet Medical Imaging-San Francisco Diagnostic Radiology CurrentSince Dec 1, 2017 Accepting new patients
Norcal Imaging Diagnostic Radiology CurrentSince Jan 23, 2018 Accepting new patients
Beverly Radiology Medical Group III Diagnostic Radiology CurrentSince Dec 24, 2016 Accepting new patients
Beverly Radiology Medical Group III Diagnostic Radiology CurrentSince Jul 1, 2016 Accepting new patients
Modesto Advanced Diagnostic Imaging Medical Center Diagnostic Radiology CurrentSince Dec 4, 2017 Accepting new patients
Palm Desert Radiology Medical Group, Inc Diagnostic Radiology PastSince Feb 4, 2024 Accepting new patients
Hni Medical Services of California, PC Past Accepting new patients
Kern Radiology Medical Group, Inc Diagnostic Radiology PastSince Aug 13, 2017 Accepting new patients

Locations (25 of 37)

4915 E Baseline Rd
Ste 116
Gilbert, AZ 85234
Phone (480) 354-9200

4915 E Baseline Rd
Gilbert, AZ 85234
Phone (480) 632-2004

18523 Corwin Rd
Ste J
Apple Valley, CA 92307
Phone (760) 242-4444

8750 Wilshire Blvd
Ste 100
Beverly Hills, CA 90211
Phone (310) 689-3100

2601 W Alameda Ave
Ste 101
Burbank, CA 91505
Phone (818) 843-7462

801 S Main St
Ste 101
Corona, CA 92882
Phone (951) 682-1099

801 S Main St
Ste 205
Corona, CA 92882
Phone (951) 351-1025

16311 Ventura Blvd
Ste 120
Encino, CA 91436
Phone (818) 817-7707

16130 Ventura Blvd
Ste 100
Encino, CA 91436
Phone (818) 933-2020

2201 Walnut Ave
Ste 150
Fremont, CA 94538
Phone (510) 713-1234

6191 N Thesta St
Fresno, CA 93710
Phone (559) 435-7200

6107 N Fresno St
Ste 101
Fresno, CA 93710
Phone (559) 435-4433

9191 Westminster Ave
Ste 105
Garden Grove, CA 92844
Phone (714) 583-6314

250 S 12th Ave
Hanford, CA 93230
Phone (559) 295-2450

2679 Zoe Ave
Huntington Park, CA 90255
Phone (323) 584-3333

11360 Mountain View Ave
Ste C
Loma Linda, CA 92354
Phone (909) 478-3300

3320 N Los Coyotes Diagonal
Ste 112
Long Beach, CA 90808
Phone (562) 627-0903

3715 E South St
Long Beach, CA 90805
Phone (562) 602-0700

3320 N Los Coyotes Diagonal
Ste 120
Long Beach, CA 90808
Phone (562) 627-0903

1516 Cotner Ave
Los Angeles, CA 90025
Phone (310) 445-2843

27168 Newport Rd
Ste B
Menifee, CA 92584
Phone (951) 566-5725

157 E Coolidge Ave
Modesto, CA 95350
Phone (209) 524-6800

25395 Hancock Ave
#1101112
Murrieta, CA 92562
Phone (951) 696-4230

3909 Waring Rd
Ste Bc
Oceanside, CA 92056
Phone (760) 630-0014

72855 Fred Waring Dr
Palm Desert, CA 92260
Phone (760) 837-1420

Organizations & group practices 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982731311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4313",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913654313",
            "telephone_number": "805-375-8800",
            "fax_number": "805-375-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 BEVERLY BLVD",
            "address_2": "ROOM M335",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90048",
            "telephone_number": "310-423-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUTCH",
        "first_name": "KENNETH",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G71093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G710930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.