PATRICIA MARIE KETTLEHAKE MD
NPI 1831109982
Pediatrics in Coronado, CA
About Patricia Marie Kettlehake Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PATRICIA MARIE KETTLEHAKE MD (NPI 1831109982) is an individual pediatrics provider in Coronado, California, licensed in California (A68312) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through September 7, 2026, and is a graduate of University Of Toledo College Of Medicine (1995).
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 3
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Patricia Marie Kettlehake Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 05D0977865
Patricia Kettlehake MD · Coronado, CAAreas of Expertise CMS Part B claims 2
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92118 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Referred Medical Equipment & Supplies CMS DME claims 3
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CORONADO, CA 92118
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 Patricia Kettlehake's NPI number?
The NPI number for Patricia Kettlehake is 1831109982. It was assigned to this individual provider in the NPPES registry on August 9, 2006.
Where is Patricia Kettlehake located?
Patricia Kettlehake practices at 230 Prospect Pl Ste 220, Coronado, CA 92118. The listed phone number is (619) 435-2670.
What is Patricia Kettlehake's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Patricia Kettlehake enrolled in Medicare?
Yes. Patricia Kettlehake is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Does Patricia Kettlehake hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 05D0977865) is associated with this NPI, valid through September 7, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Patricia Kettlehake was last updated on October 19, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Patricia Marie Kettlehake, MD · NPI 1831109982
Pediatrics physician in Coronado, California. Individual provider, active in the CMS NPPES registry since August 9, 2006.
## Identity
- **NPI:** 1831109982 (Entity type: Individual)
- **Enumerated:** August 9, 2006
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** A68312 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 230 PROSPECT PL, STE 220, Coronado, CA 92118-1978
- **Phone:** (619) 435-2670
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** University Of Toledo College Of Medicine, class of 1995
## Record status
- **NPPES last updated:** October 19, 2017
- **Other identifiers:** Medicare UPIN G99833; Medicare ID-Type Unspecified A68312 (CA); Medicaid 00A683120 (CA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1831109982) · Data from the CMS NPPES public registry.