Individual provider Active NPI

Emily Kathleen Garavatti, MD

  • Pediatric Neurodevelopmental Disabilities Physician
  • Orange, CA
National Provider Identifier
1013412873
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Neurodevelopmental Disabilities PhysicianTaxonomy code 2080P0008X
License
A198552 Issued in CA
Practice address
505 S Main St Ste 350
Orange, CA 92868-4524
Phone
(714) 509-7982
Fax
(855) 246-2329
NPI assigned
Mar 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Neurodevelopmental Disabilities Physician 2080P0008X MD200556 OR
Pediatric Neurodevelopmental Disabilities Physician 2080P0008X A198552 CA Primary

Addresses

Primary practice location

505 S Main St Ste 350
Orange, CA 92868-4524

Mailing address

1201 W la Veta Ave
Orange, CA 92868-4203
Phone (714) 509-7982

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20180924001480 OR Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 5698026037

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A198552CAMDPediatric Neurodevelopmental Disabilities Physician
MD200556ORMDPediatric Neurodevelopmental Disabilities Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Subspecialty Faculty, Inc. Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: egaravatti101897@direct.ohsu.edu

Organizations & group practices 1

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": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1013412873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W LA VETA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684203",
            "telephone_number": "714-509-7982",
            "fax_number": "855-246-2329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S MAIN ST STE 350",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684524",
            "telephone_number": "714-509-7982",
            "fax_number": "855-246-2329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARAVATTI",
        "first_name": "EMILY",
        "middle_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "OR",
            "license": "MD200556",
            "primary": false
        },
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "CA",
            "license": "A198552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.