Individual provider Active NPI

Bharathi S Vayuvegula, MD

  • General Practice Physician
  • Glendora, CA
National Provider Identifier
1023044476
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A73424 Issued in CA
Practice address
1624 S Grand Ave
Glendora, CA 91740-5433
Phone
(626) 914-0174
Fax
(626) 914-2008
NPI assigned
Jun 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A73424 CA Primary

Addresses

Primary practice location

1624 S Grand Ave
Glendora, CA 91740-5433

Mailing address

1624 S Grand Ave
Glendora, CA 91740-5433
Phone (626) 914-0174

Other identifiers 1

IdentifierTypeStateIssuer
00A7324MedicaidCA

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
I20050510000551 CA Practitioner - General PracticePractitioner - Pediatric Medicine 4688614522 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Pediatric Medicine
Education
Other, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

20540 Arrow Hwy
Suite B
Covina, CA 91724

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A73424CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
KND Development 59 LLC Current Accepting new patients
Physicians of Southern California Inc CurrentSince Mar 1, 2023 Accepting new patients
KND Develpment 59 LLC CurrentSince Apr 22, 2018 Accepting new patients
San Dimas Community Hospital, Inc. Past Accepting new patients
Emanate Health Foothill Presbyterian Hospital Past Accepting new patients
Ahmc Greater El Monte Comm Hosp LLC Past Accepting new patients
Ahmc San Gabriel Valley Medical Past Accepting new patients

Locations

20540 E Arrow Hwy
Ste B
Covina, CA 91724
Phone (626) 364-3245

1624 S Grand Ave
Glendora, CA 91740
Phone (626) 859-2249

5525 W Slauson Ave
Los Angeles, CA 90056
Phone (310) 642-0325

3235 E Colorado Blvd
Ste 102
Pasadena, CA 91107
Phone (626) 859-2249

1901 College Ave
Santa Ana, CA 92706
Phone (714) 564-7800

845 N Lark Ellen Ave
West Covina, CA 91791
Phone (626) 339-5451

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: drvee@anandamed.officeally.direct

Organizations & group practices 7

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": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1023044476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1624 S GRAND AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917405433",
            "telephone_number": "626-914-0174",
            "fax_number": "626-914-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 S GRAND AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917405433",
            "telephone_number": "626-914-0174",
            "fax_number": "626-914-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAYUVEGULA",
        "first_name": "BHARATHI",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A73424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A7324",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.