NPIMap

Individual provider Active NPI

Vivaik Tyagi, M.D.

  • Gastroenterology Physician
  • Lancaster, CA
National Provider Identifier
1073612545
Registry record updated May 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A78333 Issued in CA
Practice address
1331 W Avenue J Ste 202
Lancaster, CA 93534
Phone
(661) 529-7550
Fax
(661) 520-7560
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A78333 CA Primary

Addresses

Primary practice location

1331 W Avenue J Ste 202
Lancaster, CA 93534

Mailing address

PO Box 5688
Lancaster, CA 93539-5688
Phone (661) 948-0803

Other practice location 1

1331 W Avenue J Ste 202
Lancaster, CA 93534
Phone (661) 529-7550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070510000491 CA Practitioner - Gastroenterology 4486682556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gastro Care InstituteGroup PAC ID 7214273481, 12 clinicians

Practice addresses (Care Compare)

43944 15TH St W
Lancaster, CA 93534-5207

900 N Heritage Dr
Suite B
Ridgecrest, CA 93555-5543
Phone (661) 529-7550

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy364
Upper gastrointestinal (GI) endoscopy for acid reflux822

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
78333CAMDPharmacist
A78333CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gastro Care Institute Gastroenterology CurrentSince Oct 3, 2018 Accepting new patients
Apollo Surgery Center LLC Current Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Antelope Valley Health Care District Past Accepting new patients
Lancaster Hospital Corporation Past Accepting new patients
Advanced Endoscopy and Pain Center LLC PastSince Oct 1, 2013 Accepting new patients

Locations

1331 W Avenue J
Ste 202
Lancaster, CA 93534
Phone (661) 529-7550

43944 15th St W
Lancaster, CA 93534
Phone (661) 529-7550

43944 15th St W
Ste 201
Lancaster, CA 93534
Phone (661) 529-7550

43944 15th St W
Ste 101
Lancaster, CA 93534
Phone (661) 579-4700

43944 15th St W
#201
Lancaster, CA 93534

1535 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-2196

900 N Heritage Dr
Ste B
Ridgecrest, CA 93555
Phone (661) 529-7550

20211 W Valley Blvd
Tehachapi, CA 93561
Phone (661) 443-0088

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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 6

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558656000000",
    "number": "1073612545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5688",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935395688",
            "telephone_number": "661-948-0803",
            "fax_number": "661-948-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 W AVENUE J STE 202",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "93534",
            "telephone_number": "661-529-7550",
            "fax_number": "661-520-7560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1331 W Avenue J Ste 202",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "CA",
            "postal_code": "93534",
            "country_code": "US",
            "telephone_number": "661-529-7550",
            "fax_number": "661-520-7560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TYAGI",
        "first_name": "VIVAIK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2019-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A78333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.