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KETCHUM HEALTH MEDICAL CLINIC
NPI 1174037493
Clinic/Center - Multi-Specialty in Anaheim, CA

Active since November 22, 2017
5460 E LA PALMA AVE, ANAHEIM, CA 92807(714) 463-7500 Get Directions Write a Review

NPPES record last updated: January 18, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 2, 2023, Nov 22, 2017 (2 updates tracked since 2017).

About Ketchum Health Medical Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KETCHUM HEALTH MEDICAL CLINIC (NPI 1174037493) is a healthcare organization registered as a multi-specialty in Anaheim, California and active in the NPI registry since November 2017. The organization lists Brandon Grove, Director Of Medical Clinics, as its authorized official.

NPPES Registry Identity

NPI1174037493
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameMARSHALL B. KETCHUM UNIVERSITY
Location Address5460 E LA PALMA AVEAnaheim, CA 92807-2023
Mailing Address5460 E La Palma AveAnaheim, CA 92807-2023
Phone(714) 463-7500
Organization SubpartNo
Authorized OfficialBrandon GroveDirector Of Medical Clinics · (714) 992-7818
Enumeration DateNovember 22, 2017
Last NPPES UpdateJanuary 18, 20242 updates tracked since enumeration
NPPES CertifiedJanuary 18, 2024
✔ NPI 1174037493 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
Also ListedPharmacistTaxonomy 183500000X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedPhysician AssistantTaxonomy 363A00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
5460 E LA PALMA AVE, Anaheim, CA 92807
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Other Names 1

Doing Business AsKetchum Health Medical Clinic

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ketchum Health Medical Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

130

Medicare enrollment records show 130 clinicians reassign Medicare billing to Ketchum Health Medical Clinic, which bills Medicare for the services they deliver. Of these, 14 practice at this address and 50 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 3

Optometry116
Ophthalmology12
Family Practice2

Nearest to this location (20)

See all 130
Natalie Breau
Optometry
NPI 1841931003
5460 E LA PALMA AVE
Anaheim, CA 92807
(714) 206-1752
✔ PECOS✔ Accepts MedicareSame address
Anne Cho
Optometry
NPI 1407545981
5460 E LA PALMA AVE
Anaheim, CA 92807
(714) 463-7500
✔ PECOS✔ Accepts MedicareSame address
Ashley Deemer, O.D.
Optometry
NPI 1376837310
5460 E LA PALMA AVE
Anaheim, CA 92807
(714) 463-7500
✔ PECOS✔ Accepts MedicareSame address
Cindy Lam, OD, ABOC
Optometry
NPI 1790404986
5460 E LA PALMA AVE
Anaheim, CA 92807
(714) 463-7593
✔ PECOSSame address
Dawn Lam, O.D.
Optometry
NPI 1720081029
5460 E LA PALMA AVE
Anaheim, CA 92807
(714) 463-7500
✔ PECOS✔ Accepts MedicareSame address
Valerie Lim, OD
Optometry
NPI 1891341434
5460 E LA PALMA AVE
Anaheim, CA 92807
(714) 463-7532
✔ PECOS✔ Accepts MedicareSame address
Reena Patel, O.D.
Optometry
NPI 1528297173
5460 E LA PALMA AVE
Anaheim, CA 92807
(714) 463-7500
✔ PECOS✔ Accepts MedicareSame address
Rebecca Phung, OD
Optometry
NPI 1780326439
5460 E LA PALMA AVE
Anaheim, CA 92807
(909) 379-8543
✔ PECOS✔ Accepts MedicareSame address
Dashaini Retnasothie, OD, MSC, BSC
Optometry
NPI 1265797997
5460 E LA PALMA AVE
Anaheim, CA 92807
(714) 463-7500
✔ PECOSSame address
Sherry Shang, OD
Optometry
NPI 1659043388
5460 E LA PALMA AVE
Anaheim, CA 92807
(714) 493-7593
✔ PECOSSame address
Julie Tyler, O.D.
Optometry
NPI 1396821955
5460 E LA PALMA AVE
Anaheim, CA 92807
(714) 463-7500
✔ PECOS✔ Accepts MedicareSame address
Lauren Zabaleta, OD
Optometry
NPI 1184297806
5460 E LA PALMA AVE
Anaheim, CA 92807
(714) 463-7594
✔ PECOSSame address
Katherine Zhang, OD
Optometry
NPI 1144714494
5460 E LA PALMA AVE
Anaheim, CA 92807
(714) 463-7500
✔ PECOS✔ Accepts MedicareSame address
Tina Zheng, O.D.
Optometry
NPI 1669866414
5460 E LA PALMA AVE
Anaheim, CA 92807
(714) 463-7578
✔ PECOS✔ Accepts MedicareSame address
Jun Wing Chen, OD
Optometry
NPI 1073354478
5460 E LA PALMA AVE
Anaheim, CA 92807
(714) 449-7404
✔ PECOS✔ Accepts Medicare0.2 mi
Jeremiah Seth Evasco, OD
Optometry
NPI 1295661726
5460 E LA PALMA AVE
Anaheim, CA 92807
(714) 449-7400
✔ PECOS0.2 mi
Samantha Ito, OD
Optometry
NPI 1386561280
5460 E LA PALMA AVE
Anaheim, CA 92807
(714) 992-7833
✔ PECOS✔ Accepts Medicare0.2 mi
Diana Pajongvirotjanasakul, OD
Optometry
NPI 1811746035
5460 E LA PALMA AVE
Anaheim, CA 92807
(714) 463-7250
✔ PECOS0.2 mi
Tiffany Park, OD, MS
Optometry
NPI 1689414914
5460 E LA PALMA AVE
Anaheim, CA 92807
(714) 463-7500
✔ PECOS✔ Accepts Medicare0.2 mi
Anjli Patel
Optometry
NPI 1699565960
5460 E LA PALMA AVE
Anaheim, CA 92807
(714) 463-7500
✔ PECOS0.2 mi
See all 130 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marshall B. Ketchum University's NPI number?

The NPI number for Marshall B. Ketchum University is 1174037493. It was assigned to this organization in the NPPES registry on November 22, 2017. The provider is doing business as Ketchum Health Medical Clinic.

Where is Marshall B. Ketchum University located?

Marshall B. Ketchum University is located at 5460 E La Palma Ave, Anaheim, CA 92807. The listed phone number is (714) 463-7500.

What is Marshall B. Ketchum University's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Is Marshall B. Ketchum University enrolled in Medicare?

Yes. Marshall B. Ketchum University is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Marshall B. Ketchum University?

According to the CMS Revalidation Reassignment List (October 2026 release), 130 clinicians in 3 Medicare specialties reassign their Medicare billing to Marshall B. Ketchum University. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Optometry (116), Ophthalmology (12) and Family Practice (2). Of these, 14 practice at this address and 50 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Marshall B. Ketchum University was last updated on January 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.