Individual provider Active NPI

Ravindra Rao, M.D.

  • Pediatrics Physician
  • Loma Linda, CA
National Provider Identifier
1154344760
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A32898 Issued in CA
Practice address
11370 Anderson St
Ste B-100
Loma Linda, CA 92354-3450
Phone
(909) 558-2848
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A32898 CA Primary

Addresses

Primary practice location

11370 Anderson St
Ste B-100
Loma Linda, CA 92354-3450

Mailing address

54701 File Number
Los Angeles, CA 90074-4701
Phone (909) 558-3111

Other identifiers 1

IdentifierTypeStateIssuer
00A328980MedicaidCA

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
I20040324000500 CA Practitioner - Pediatric Medicine 0244121564 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A32898CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince Feb 28, 1978 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Feb 28, 1978 Accepting new patients
Faculty Physicians and Surgeons of Llusm Pediatrics Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Pediatrics Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients

Locations

7223 Church St
Ste C1
Highland, CA 92346
Phone (909) 425-3946

82934 Civic Center Dr
Indio, CA 92201
Phone (760) 477-0733

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

11370 Anderson St
Ste B100
Loma Linda, CA 92354
Phone (909) 558-2848

25845 Barton Rd
Ste F
Loma Linda, CA 92354
Phone (909) 558-2828

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

11401 Heacock St
Ste 330
Moreno Valley, CA 92557
Phone (951) 247-8697

11441 Heacock St
Ste C
Moreno Valley, CA 92557
Phone (951) 247-5809

2195 Club Center Dr
Ste A
Sn Bernrdno, CA 92408
Phone (909) 835-1750

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Totally Kids Rehabilitation HospitalLoma Linda, CA, CCN 053038 Hospital Corporate Director Jun 14, 2014
Totally Kids Rehabilitation HospitalLoma Linda, CA, CCN 555587 Skilled nursing facility Corporate Director
Operational/Managerial Control
Managing Control - Governing Body
Jun 14, 2014
Jun 14, 2014
Jun 14, 2014

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154344760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54701 FILE NUMBER",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900744701",
            "telephone_number": "909-558-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11370 ANDERSON ST",
            "address_2": "STE B-100",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543450",
            "telephone_number": "909-558-2848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAO",
        "first_name": "RAVINDRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A32898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A328980",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.