KESARA BORIRAKCHANYAVAT (MD) – Dermatology Physician, NPI 1962580506

KESARA BORIRAKCHANYAVAT (MD) is a healthcare provider. based in Panorama city, California. specializing in DERMATOLOGY. They hold the professional credentials MD. They hold a License No. A76396 (CA). The NPI Number for KESARA BORIRAKCHANYAVAT (MD) is 1962580506

Main info

Female
29 Years Of Experience
Accepts Medicare Assignment
Name
KESARA BORIRAKCHANYAVAT (MD)
NPI
1962580506
Phone
(818) 375-3030
Address
13652 CANTARA ST
Enumeration Date
1 November 2006
Last Update Date
29 November 2021

Doctor Profile

Medical School Name
UNIVERSITY OF CHICAGO, PRITZKER SCHOOL OF MEDICINE
Secondary Phone
6612222323
Graduation Year
1997 (29 years ago)
PAC ID
9638350630
Group Practice PAC ID
6002729175
Professional Enrollment ID
I20110224000095
Address ID
CA913551860SA27107RDXX300

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

2,140 DERMATOLOGY in CA

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Provider Addresses for KESARA BORIRAKCHANYAVAT (MD)

  • 13652, Cantara Street, Panorama City, Los Angeles, Los Angeles County, California, 91402, United States

    PANORAMA CITY, CA 914025423

    Phone: (818) 375-3030

    Type: Location

  • 4285, Farmdale Avenue, Studio City Neighborhood Council District, Los Angeles, Los Angeles County, California, 91604, United States

    STUDIO CITY, CA 916042734

    Phone: (415) 377-0999

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-02-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110224000095IDermatologyCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 91402)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6002729175View full group profile
NameSpecialtyState
U R O L O G YOH
Nurse PractitionerCA
Internal MedicineCA
Internal MedicineCA
Internal Medicine, GastroenterologyCA
Physician AssistantCA
Emergency MedicineNC
O P H T H A L M O L O G YCA
Anesthesiology, Pain ManagementNH
Family Practice, Sports MedicineCA

Reviews

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Frequently asked questions

What is the standard ID for KESARA BORIRAKCHANYAVAT (MD) in the U.S.?
In the U.S., KESARA BORIRAKCHANYAVAT (MD) is identified by NPI 1962580506.
Is KESARA BORIRAKCHANYAVAT (MD) currently accepting referrals based on NPI status?
Registry metadata lists KESARA BORIRAKCHANYAVAT (MD) as active.
What type of care does KESARA BORIRAKCHANYAVAT (MD) provide?
KESARA BORIRAKCHANYAVAT (MD)'s profile centers on Dermatology Physician. Clinical services aligned with this taxonomy classification.
Is KESARA BORIRAKCHANYAVAT (MD) tied to Panorama City, California?
If you are local to Panorama City, California, KESARA BORIRAKCHANYAVAT (MD) may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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