Individual provider Active NPI

Rita Sheth, MD

  • Pediatric Nephrology Physician
  • Loma Linda, CA
National Provider Identifier
1003996448
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
C52808 Issued in CA
Practice address
11175 Campus St
Loma Linda, CA 92350-1700
Phone
(909) 558-8242
Fax
(909) 558-0479
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X K6322 TX
Pediatric Nephrology Physician 2080P0210X C52808 CA Primary

Addresses

Primary practice location

11175 Campus St
Loma Linda, CA 92350-1700

Mailing address

11175 Campus St
Loma Linda, CA 92350-1700
Phone (909) 558-4000

Other identifiers 1

IdentifierTypeStateIssuer
118396403MedicaidTX

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
I20091219000042 CA Practitioner - NephrologyPractitioner - Pediatric Medicine 1153461348 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C52808CAMDPediatric Nephrology Physician
K6322TXMDPediatric Nephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Feb 12, 2011 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Feb 12, 2011 Accepting new patients
Pediatric Subspecialty Faculty, Inc. Past Accepting new patients

Locations

82934 Civic Center Dr
Indio, CA 92201
Phone (760) 477-0733

25845 Barton Rd
Ste F
Loma Linda, CA 92354
Phone (909) 558-2828

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

2195 Club Center Dr
Ste A
Sn Bernrdno, CA 92408
Phone (909) 835-1750

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: rsheth11136@direct.llu.edu

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1003996448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11175 CAMPUS ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501700",
            "telephone_number": "909-558-4000",
            "fax_number": "909-558-0479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11175 CAMPUS ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501700",
            "telephone_number": "909-558-8242",
            "fax_number": "909-558-0479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETH",
        "first_name": "RITA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "TX",
            "license": "K6322",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "CA",
            "license": "C52808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118396403",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.