Individual provider Active NPI

Uma P Rao, MD

  • Internal Medicine Physician
  • Fullerton, CA
National Provider Identifier
1043371479
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A77005 Issued in CA
Practice address
1400 N Harbor Blvd
Suite 120
Fullerton, CA 92835-4126
Phone
(714) 992-2765
Fax
(714) 681-9015
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A77005 CA Primary

Addresses

Primary practice location

1400 N Harbor Blvd
Suite 120
Fullerton, CA 92835-4126

Mailing address

7965 Sierra Ave
Ste E
Fontana, CA 92336-3329
Phone (714) 992-2765

Other identifiers 1

IdentifierTypeStateIssuer
00A770050MedicaidCA

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
I20040122001171 CA Practitioner - Internal MedicinePractitioner - General Practice 5698677367 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: General Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Marcos Medical Group IncGroup PAC ID 0749222495, 8 clinicians

Practice addresses (Care Compare)

14980 Summit Ave
Suite 230
Fontana, CA 92336-5390
Phone (909) 803-1160

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
77005CAMDPharmacist
A77005CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Marcos Medical Group Inc CurrentSince Jun 28, 2014 Accepting new patients
San Marcos Medical Group Inc. Past Accepting new patients
San Marcos Medical Group Inc. Past Accepting new patients
San Marcos Medical Group Inc. Past Accepting new patients

Locations

7965 Sierra Ave
Ste E
Fontana, CA 92336
Phone (909) 356-4459

14980 Summit Ave
Ste 230
Fontana, CA 92336
Phone (909) 803-1160

742 W Highland Ave
Sn Bernrdno, CA 92405
Phone (909) 881-7320

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: uma.rao.p1@direct.metro.nextgenshare.com

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1043371479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7965 SIERRA AVE",
            "address_2": "STE E",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923363329",
            "telephone_number": "714-992-2765",
            "fax_number": "714-681-9015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N HARBOR BLVD",
            "address_2": "SUITE 120",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928354126",
            "telephone_number": "714-992-2765",
            "fax_number": "714-681-9015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAO",
        "first_name": "UMA",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A77005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A770050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.