NPIMap

Individual provider Active NPI

Vatsal Haren Mody, MD

  • Cardiovascular Disease Physician
  • Rancho Cucamonga, CA
National Provider Identifier
1083790117
Registry record updated Jul 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A56472 Issued in CA
Practice address
10832 Laurel St Ste 101
Rancho Cucamonga, CA 91730
Phone
(909) 477-3015
NPI assigned
Oct 31, 2006
Last updated
Jul 25, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A56472 CA Primary

Addresses

Primary practice location

10832 Laurel St Ste 101
Rancho Cucamonga, CA 91730

Mailing address

10832 Laurel St Ste 101
Rancho Cucamonga, CA 91730
Phone (909) 477-3015

Other identifiers 1

IdentifierTypeStateIssuer
00A564720MedicaidCA

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
I20040130000367 CA Practitioner - Cardiac SurgeryPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5890694111 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac SurgeryAlso: Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

10832 Laurel St
Suite 101
Rancho Cucamonga, CA 91730-7688
Phone (909) 477-3015

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
41.05 of 100Reported as individual
Quality
36.34
Improvement activities
0
Cost
73.07

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vatsal Haren Mody M.D. Inc. Cardiovascular Disease CurrentSince Oct 11, 2003 Accepting new patients
KND Development 59 LLC CurrentSince Oct 1, 2011 Accepting new patients
KND Development 59 LLC Current Accepting new patients
Cardiac Imaging Inc CurrentSince Sep 1, 2023 Accepting new patients
KND Development 59, LLC CurrentSince Oct 1, 2011 Accepting new patients
Casa Colina Hospital and Centers for Healthcare Current Accepting new patients
Yong Luke Lee Medical Corporation Past Accepting new patients
San Antonio Regional Hospital Past Accepting new patients
B Don Ahn MD Inc Cardiovascular Disease Past Accepting new patients

Locations

10832 Laurel St
Ste 101
Rch Cucamonga, CA 91730
Phone (909) 477-3015

10841 White Oak Ave
Rch Cucamonga, CA 91730
Phone (626) 914-1514

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: casacolina@direct.casacolina.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/RNC0mGAiXtkLtK00WOVGaq2OiSLKKj4V/

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343174400000",
    "number": "1083790117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10832 LAUREL ST STE 101",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "91730",
            "telephone_number": "909-477-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10832 LAUREL ST STE 101",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "91730",
            "telephone_number": "909-477-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODY",
        "first_name": "VATSAL",
        "middle_name": "HAREN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2012-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A56472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A564720",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.