Kenneth R Diddie (NPI# 1184684219, PAC ID# 4981682580) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPHTHALMOLOGY.
| Nation Provider ID (NPI) | 1184684219 |
| PAC ID by PECOS | 4981682580 |
| Professional Enrollment ID | I20111212000435 |
| Full Name | Kenneth R Diddie |
| Address |
12304 Santa Monica Blvd Suite 117 Los Angeles CA 90025-2586 |
| Gender | M |
| Medical School | UNIVERSITY OF CHICAGO, PRITZKER SCHOOL OF MEDICINE |
| Graduation Year | 1973 |
| Primary Specialty | OPHTHALMOLOGY |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 12304 Santa Monica Blvd, Suite 117, Los Angeles, CA 90025-2586 | ||
| 1220 La Venta Dr, Suite 211, Westlake Village, CA 91361-3724 |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_3 | Specialized Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| MIPS_EC_014_overall | Age-Related Macular Degeneration (AMD): Dilated Macular Examination | 100% | |
| MIPS_EC_117_overall | Diabetes: Eye Exam | 100% | |
| MIPS_EC_140_overall | Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement | 100% |
| Street Address |
12304 SANTA MONICA BLVD SUITE 117 |
| City | LOS ANGELES |
| State | CA |
| Zip | 90025-2586 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sean Pakdaman | Psychologist, Clinical | 12304 Santa Monica Blvd, Suite 310, Los Angeles, CA 90025-1594 | |
| John L Garwood | Ophthalmology | 12304 Santa Monica Blvd, Suite 117, Los Angeles, CA 90025-2586 | |
| Kevin James Fitzsimmons | Clinical Social Worker | 12304 Santa Monica Blvd, Suite 108a, Los Angeles, CA 90025-2586 | |
| Howard J Newman | Psychologist, Clinical | 12304 Santa Monica Blvd, Suite 334, Los Angeles, CA 90025-2551 | |
| Ricki R Bernstein | Clinical Social Worker | 12304 Santa Monica Blvd, Suite 211, Los Angeles, CA 90025-2587 | |
| David S Gordon | Psychologist, Clinical | 12304 Santa Monica Blvd, Suite 211, Los Angeles, CA 90025-2587 | |
| Thomas M Brod | Psychiatry | 12304 Santa Monica Blvd, Suite 210, Los Angeles, CA 90025-2587 | |
| Arash Noor | Chiropractic | 12304 Santa Monica Blvd, Suite 322, Los Angeles, CA 90025-2551 | |
| Rachael Bloom | Clinical Social Worker | 12304 Santa Monica Blvd, Suite 215a, Los Angeles, CA 90025-2587 | |
| Lillian Freeman | Clinical Social Worker | 12304 Santa Monica Blvd, Suite 215, Los Angeles, CA 90025-2587 | |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Deborah Galligani | Clinical Social Worker | 12340 Santa Monica Blvd, Suite 307, Los Angeles, CA 90025-0348 | |
| Bijan Nikakhtar | Nephrology | 12340 Santa Monica Blvd, West Los Angeles, CA 90025-0405 | |
| Kathy H.k. Langevin | Dermatology | Joshua M Wieder Md Inc | 12301 Wilshire Blvd, Suite 201, Los Angeles, CA 90025-1000 |
| Joshua M Wieder | Dermatology | Joshua M Wieder Md Inc | 12301 Wilshire Blvd, Suite 201, Los Angeles, CA 90025-1000 |
| Gloria Elizabeth Mucino | Clinical Social Worker | 12301 Wilshire Blvd, Suite 210, Los Angeles, CA 90025-1000 | |
| Anne V Mcarthur | Physical Therapy | 12401 Wilshire Blvd, Suite 105, Los Angeles, CA 90025-1015 | |
| Joan I Essenmacher | Physical Therapy | Peak Performance Consulting Inc | 12401 Wilshire Blvd, Suite 105, Los Angeles, CA 90025-1015 |
| Pallavi Jakatdar | Physical Therapy | Peak Performance Consulting Inc | 12401 Wilshire Blvd, Suite 105, Los Angeles, CA 90025-1015 |
| Robert Kilroy | Chiropractic | 12401 Wilshire Blvd, Suite 104, Los Angeles, CA 90025-1015 | |
| Shannon Collins | Physical Therapy | Peak Performance Consulting Inc | 12401 Wilshire Blvd, Suite 105, Los Angeles, CA 90025-1015 |
| Find all physicians in zip 90025 | |||
| City | LOS ANGELES |
| Zip Code | 90025 |
| Specialty | OPHTHALMOLOGY |
| City + Specialty | LOS ANGELES + OPHTHALMOLOGY |
Please comment or provide details below to improve the information on Kenneth R Diddie.
| 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.