Individual provider Active NPI

Shawn Raveenth Vedamani, MD

  • Anesthesiology Physician
  • San Diego, CA
National Provider Identifier
1003047531
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
116063 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
Fax
(888) 539-8781
NPI assigned
Jul 31, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 30135 OK
Anesthesiology Physician 207L00000X MD60681697 WA
Anesthesiology Physician 207L00000X ME166160 FL
Student in an Organized Health Care Education/Training Program 390200000X CA
Anesthesiology Physician 207L00000X 116063 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

File 57326
Los Angeles, CA 90074-7326
Phone (858) 249-6748

Other practice location 1

4150 Regents Park Row Ste 300
LA Jolla, CA 92037
Phone (858) 909-9000

Other practice location 2

750 NE 13th St Ste 200
Oklahoma City, OK 73104-5024
Phone (405) 271-4351

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AZ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171102000630 CA Practitioner - Anesthesiology 3971747601 Reassigns benefits to 5 organizations
I20230414001699 AZ Practitioner - Anesthesiology 3971747601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
116063CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Anesthesiology CurrentSince Aug 1, 2022 Accepting new patients
Allied Anesthesia Medical Group Inc Anesthesiology CurrentSince Mar 1, 2021 Accepting new patients
La Quality Care Anesthesia Consultants Inc Anesthesiology CurrentSince Oct 1, 2017 Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Oct 1, 2020 Accepting new patients
Regents of the University of California Anesthesiology CurrentSince Dec 4, 2023 Accepting new patients
Valley Anesthesiology Consultants, Inc. Anesthesiology CurrentSince Mar 1, 2023 Accepting new patients
Cep America - Anesthesia, PC Anesthesiology Current Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Oct 1, 2020 Accepting new patients
Sound Physicians Anesthesiology of California PC Anesthesiology CurrentSince Jul 1, 2022 Accepting new patients
Regents of the University of California CurrentSince Dec 4, 2023 Accepting new patients
Regents of the University of California Past Accepting new patients
University of California Irvine Past Accepting new patients
University of California Irvine Past Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Locations

1850 N Central Ave
Ste 1600
Phoenix, AZ 85004
Phone (602) 744-4760

6200 N La Cholla Blvd
Tucson, AZ 85741
Phone (520) 229-2657

1601 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 622-5833

2000 Mowry Ave
Fremont, CA 94538
Phone (510) 793-6653

5700 San Fernando Rd
Glendale, CA 91202
Phone (818) 637-7766

1500 E Chevy Chase Dr
Ste 101
Glendale, CA 91206
Phone (818) 265-1581

9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000

4150 Regents Park Row
Ste 300
La Jolla, CA 92037
Phone (858) 909-9000

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

File 57326
Los Angeles, CA 90074

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

28062 Baxter Rd
Murrieta, CA 92563
Phone (951) 290-4000

4002 Vista Way
Oceanside, CA 92056
Phone (760) 724-8411

455 S Main St
Orange, CA 92868
Phone (714) 289-4511

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

255 E Bonita Ave
Pomona, CA 91767
Phone (866) 724-4127

1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

6655 Alvarado Rd
San Diego, CA 92120
Phone (619) 229-3130

999 San Bernardino Rd
Upland, CA 91786
Phone (909) 920-4841

Interoperability endpoints

  • Direct secure messaging: svedamani11947@direct.llu.edu

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1003047531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 57326",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900747326",
            "telephone_number": "858-249-6748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4150 Regents Park Row Ste 300",
            "address_purpose": "LOCATION",
            "city": "LA Jolla",
            "state": "CA",
            "postal_code": "92037",
            "country_code": "US",
            "telephone_number": "858-909-9000",
            "fax_number": "858-909-9009",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "750 NE 13th St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731045024",
            "country_code": "US",
            "telephone_number": "405-271-4351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VEDAMANI",
        "first_name": "SHAWN",
        "middle_name": "RAVEENTH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-31",
        "last_updated": "2024-05-08",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "30135",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD60681697",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME166160",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "116063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.