NPIMap

Organization Active NPI

Madhu K. Kris, M.D., Inc.

  • Specialist
  • Merced, CA
National Provider Identifier
1114195229
Registry record updated Sep 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A41735 Issued in CA
Legal business name
MADHU K. KRIS, M.D., INC.
Practice address
750 W Olive Ave Ste 106
Merced, CA 95348-2436
Phone
(209) 384-3115
Fax
(209) 384-8696
NPI assigned
Feb 12, 2008
Last updated
Sep 21, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2010

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

Authorized official

Name
Ms. Michelle Chavez
Title
Billing Manager
Phone
(209) 384-3115

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A41735 CA Primary

Addresses

Primary practice location

750 W Olive Ave Ste 106
Merced, CA 95348-2436

Mailing address

750 W Olive Ave Ste 106
Merced, CA 95348-2436
Phone (209) 384-3115

Other identifiers 3

IdentifierTypeStateIssuer
00A450650OtherCAMEDICARE PROVIDER NUMBER
ZZZ20810ZOtherCAGROUP LEGACY NUMBER
SUR01293FMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050613001146 CA Part B Supplier - Clinic/Group Practice 5294779005 Receives reassigned benefits from 7 practitioners
Practice locations: Merced, CA

National Provider Directory

National Provider Directory

Locations

750 W Olive Ave
Ste 106
Merced, CA 95348
Phone (209) 384-3115

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285027200000",
    "number": "1114195229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 W OLIVE AVE STE 106",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953482436",
            "telephone_number": "209-384-3115",
            "fax_number": "209-384-8696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 W OLIVE AVE STE 106",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953482436",
            "telephone_number": "209-384-3115",
            "fax_number": "209-384-8696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADHU K. KRIS, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-12",
        "last_updated": "2010-09-21",
        "status": "A",
        "authorized_official_last_name": "CHAVEZ",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "209-384-3115",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A41735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "00A450650",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP LEGACY NUMBER",
            "identifier": "ZZZ20810Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SUR01293F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.