Individual provider Active NPI

Pravir R Vatsa, MD

  • Hospitalist Physician
  • San Luis Obispo, CA
National Provider Identifier
1003912239
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
A95811 Issued in CA
Practice address
1023 Nipomo St # 110
San Luis Obispo, CA 93401-3882
Phone
(805) 439-2998
Fax
(805) 439-2997
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A95811 CA
Hospitalist Physician 208M00000X A95811 CA Primary

Addresses

Primary practice location

1023 Nipomo St # 110
San Luis Obispo, CA 93401-3882

Mailing address

1023 Nipomo St # 110
San Luis Obispo, CA 93401-3882
Phone (805) 439-2998

Other identifiers 2

IdentifierTypeStateIssuer
00A958110MedicaidCA
00A958110OtherCABLUE SHIELD OF CA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070206000616 CA Practitioner - HospitalistPractitioner - Internal Medicine 2567464498 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Coast in-Patient Consultants IncGroup PAC ID 8325137714, 33 clinicians

Practice addresses (Care Compare)

345 S Halcyon Rd
Arroyo Grande, CA 93420-3817
Phone (805) 489-4261

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
50.33 of 100Reported as group
Quality
29.5
Improvement activities
0
Cost
80.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A95811CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Medicine of California Inc Internal Medicine CurrentSince Aug 28, 2023 Accepting new patients
Pravir R Vatsa MD a Medical Corporation Internal Medicine CurrentSince Oct 29, 2014 Accepting new patients
Central Coast Chest Consultants a Medical Corporation Internal Medicine PastSince Jul 10, 2022 Accepting new patients

Locations

1010 Murray Ave
Sn Luis Obisp, CA 93405
Phone (805) 546-7600

1100 Las Tablas Rd
Templeton, CA 93465
Phone (805) 434-3500

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1003912239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 NIPOMO ST # 110",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013882",
            "telephone_number": "805-439-2998",
            "fax_number": "805-439-2997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 NIPOMO ST # 110",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013882",
            "telephone_number": "805-439-2998",
            "fax_number": "805-439-2997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VATSA",
        "first_name": "PRAVIR",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A95811",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A95811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A958110",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "00A958110",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.