NPIMap

Individual provider Active NPI

Hetalben Makwana, MD

  • Internal Medicine Physician
  • Rancho Cucamonga, CA
National Provider Identifier
1093028078
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A121867 Issued in CA
Practice address
9190 Haven Ave Ste 102
Rancho Cucamonga, CA 91730-5431
Phone
(909) 981-0989
Fax
(909) 949-6214
NPI assigned
Jul 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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 A121867 CA Primary

Addresses

Primary practice location

9190 Haven Ave Ste 102
Rancho Cucamonga, CA 91730-5431

Mailing address

840 Towne Center Dr
Pomona, CA 91767-5900
Phone (909) 398-1550

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
I20170117001095 CA Practitioner - Internal Medicine 1951552595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Our Family Medical Group IncGroup PAC ID 8729369665, 5 clinicians

Practice addresses (Care Compare)

9190 Haven Ave
Suite 102
Rancho Cucamonga, CA 91730-5431
Phone (909) 981-0989

Hospital & facility affiliations

  • San Antonio Regional Hospital Hospital, Upland, CA, CCN 050099
  • Pomona Valley Hospital Medical Center Hospital, Pomona, CA, CCN 050231

Merit-based Incentive Payment System (MIPS)

Final score
48.59 of 100Reported as group
Quality
54.12
Improvement activities
0
Cost
84.41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A121867CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Our Family Medical Group, Inc. Internal Medicine CurrentSince Nov 19, 2016 Accepting new patients
Our Family Medical Group, Inc. Internal Medicine CurrentSince Nov 19, 2016 Accepting new patients
St Lukes Roosevelt Hospital Center Past Accepting new patients
Desert Valley Hospital, LLC Past Accepting new patients
San Antonio Regional Hospital Past Accepting new patients
Chino Medical Group, Inc Internal Medicine Past Accepting new patients
Victor Valley Community Hospital Past Accepting new patients
Southern California Healthcare System, Inc Past Accepting new patients
Doctors Hospital of Riverside LLC Past Accepting new patients

Locations

840 Towne Center Dr
Pomona, CA 91767

9190 Haven Ave
Ste 102
Rch Cucamonga, CA 91730
Phone (909) 527-8110

1330 San Bernardino Rd
Ste G
Upland, CA 91786
Phone (909) 755-0622

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BJEJBA/Endpoint/BJEJBA

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1279584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1093028078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 TOWNE CENTER DR",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675900",
            "telephone_number": "909-398-1550",
            "fax_number": "909-398-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9190 HAVEN AVE STE 102",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305431",
            "telephone_number": "909-981-0989",
            "fax_number": "909-949-6214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKWANA",
        "first_name": "HETALBEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-20",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A121867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.