Andrew P Kelly (NPI# 1316920895, PAC ID# 1850335795) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1316920895 |
| PAC ID by PECOS | 1850335795 |
| Professional Enrollment ID | I20050613000487 |
| Full Name | Andrew P Kelly |
| Organization Legal Name | CENTINELA RADIOLOGY MEDICAL GROUP |
| Address |
555 E Hardy St Centinela Hospital Medical Center Inglewood CA 90307-4011 |
| Phone Number | 3106734660 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF CALIFORNIA, CALIFORNIA COLLEGE OF MEDICINE |
| Graduation Year | 1988 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 3476440215 |
| Number of Group Practice Members | 7 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050740 | MARINA DEL REY HOSPITAL |
| 050739 | CENTINELA HOSPITAL MEDICAL CENTER |
| 050290 | PROVIDENCE SAINT JOHN'S HEALTH CENTER |
| 050625 | CEDARS-SINAI MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 211 N Prairie Ave, Inglewood, CA 90301-1412 | 3108550556 | ICM MEDICAL GROUP INC |
| 555 E Hardy St, Centinela Hospital Medical Center, Inglewood, CA 90307-4011 | 3106734660 | CENTINELA RADIOLOGY MEDICAL GROUP |
| Organization Legal Name | CENTINELA RADIOLOGY MEDICAL GROUP |
| Physicians | 7 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher E Herzig | Diagnostic Radiology | Centinela Radiology Medical Group | 555 E Hardy St, Centinela Hospital Medical Center, Inglewood, CA 90307-4011 |
| Craig Gomberg | Diagnostic Radiology | Centinela Radiology Medical Group | 555 E Hardy St, Centinela Hospital Medical Center, Inglewood, CA 90307-4011 |
| Michael J Dawson | Diagnostic Radiology | Centinela Radiology Medical Group | 555 E Hardy St, Centinela Hospital Medical Center, Inglewood, CA 90307-4011 |
| Donald S Mayekawa | Diagnostic Radiology | Centinela Radiology Medical Group | 555 E Hardy St, Centinela Hospital Medical Center, Inglewood, CA 90307-4011 |
| John B Braunstein | Diagnostic Radiology | Centinela Radiology Medical Group | 555 E Hardy St, Centinela Hospital Medical Center, Inglewood, CA 90307-4011 |
| Michael S Shaub | Diagnostic Radiology | Centinela Radiology Medical Group | 4650 Lincoln Blvd, Marina Del Rey, CA 90292-6360 |
| Street Address |
555 E HARDY ST CENTINELA HOSPITAL MEDICAL CENTER |
| City | INGLEWOOD |
| State | CA |
| Zip | 90307-4011 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David F Razi | Internal Medicine | Centinela Hospitalist Medical Group Inc | 555 E Hardy St, Inglewood, CA 90301-4011 |
| Christopher E Herzig | Diagnostic Radiology | Centinela Radiology Medical Group | 555 E Hardy St, Centinela Hospital Medical Center, Inglewood, CA 90307-4011 |
| Broderick J Franklin | Emergency Medicine | Centinela Freeman Emergency Medical Associates, Inc. | 555 E Hardy St, Inglewood, CA 90301-4011 |
| Geoffrey M Smith | Emergency Medicine | Centinela Freeman Emergency Medical Associates, Inc. | 555 E Hardy St, Inglewood, CA 90301-4011 |
| Lincoln Luk Jr. | Pathology | 555 E Hardy St, Inglewood, CA 90301-4011 | |
| Elham Ghadishah | Internal Medicine | Centinela Hospitalist Medical Group Inc | 555 E Hardy St, Inglewood, CA 90301-4011 |
| Anastasia Eugene Kwon | Anesthesiology | Landmark Anesthesia Medical Group | 555 E Hardy St, Inglewood, CA 90301-4011 |
| Craig Gomberg | Diagnostic Radiology | Centinela Radiology Medical Group | 555 E Hardy St, Centinela Hospital Medical Center, Inglewood, CA 90307-4011 |
| Alexandra M Dyer | Emergency Medicine | Centinela Freeman Emergency Medical Associates, Inc. | 555 E Hardy St, Inglewood, CA 90301-4011 |
| Mohsen Kheradpezhouh | Internal Medicine | 555 E Hardy St, Inglewood, CA 90301-4011 | |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael J Dawson | Diagnostic Radiology | Centinela Radiology Medical Group | 555 E Hardy St, Centinela Hospital Medical Center, Inglewood, CA 90307-4011 |
| Donald S Mayekawa | Diagnostic Radiology | Centinela Radiology Medical Group | 555 E Hardy St, Centinela Hospital Medical Center, Inglewood, CA 90307-4011 |
| John B Braunstein | Diagnostic Radiology | Centinela Radiology Medical Group | 555 E Hardy St, Centinela Hospital Medical Center, Inglewood, CA 90307-4011 |
| City | INGLEWOOD |
| Zip Code | 90307 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | INGLEWOOD + DIAGNOSTIC RADIOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.