DR. CLINT KETCHEL M.D.
NPI 1699038125
Family Medicine in Lake Elsinore, CA

Q: What is Clint Ketchel's NPI number?

The NPI number for Clint Ketchel is 1699038125. It was assigned to this individual provider in the NPPES registry on June 19, 2012.

Q: What is Clint Ketchel's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Clint Ketchel was last updated on February 1, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since June 19, 2012PECOS Enrolled

30195 FRASER DR, LAKE ELSINORE, CA 92530(951) 252-2720(760) 414-3892 Get Directions Write a Review

NPPES record last updated: February 1, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 1, 2019, Dec 2, 2015, Nov 20, 2015 (3 updates tracked since 2015).

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About Dr. Clint Ketchel M.d. NPPES

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

DR. CLINT KETCHEL M.D. (NPI 1699038125) is an individual family medicine provider in Lake Elsinore, California, licensed in California (A135564) and active in the NPI registry since June 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1699038125

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. CLINT KETCHELCredential: M.D.

Location Address30195 FRASER DRLake Elsinore, CA 92530-7006

Mailing Address1000 Vale Terrace DrVista, CA 92084-5218 · (760) 631-5000 · Fax (760) 414-3892

Phone(951) 252-2720

Fax(760) 414-3892

Sole ProprietorNo

Enumeration DateJune 19, 2012

Last NPPES UpdateFebruary 1, 20193 updates tracked since enumeration

✔ NPI 1699038125 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in CA · A135564✔ Licensed in MI · 4301100963

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

30195 FRASER DR, Lake Elsinore, CA 92530

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Clint Ketchel M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92530 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$91.88 typical visit price

range $59.60 – $179.42

Typical copayment $22.97 (range $14.90 – $44.85)

Most-billed visit code 99203

Established Patient

$104.64 typical visit price

range $19.37 – $146.42

Typical copayment $26.16 (range $4.84 – $36.60)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

6 suppliers13 claims23 services$4.61 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

2 suppliers15 claims15 services$38.97 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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