Individual provider Active NPI

Divya Vats, MD

  • Clinical Biochemical Genetics Physician
  • Los Angeles, CA
National Provider Identifier
1154515963
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Biochemical Genetics PhysicianTaxonomy code 207SG0202X
License
A107303 Issued in CA
Practice address
4650 W Sunset Blvd
Mail Stop # 90
Los Angeles, CA 90027-6062
Phone
(323) 361-2178
Fax
(323) 361-1172
NPI assigned
Sep 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X R8236 IA
Clinical Biochemical Genetics Physician 207SG0202X A107303 CA Primary

Addresses

Primary practice location

4650 W Sunset Blvd
Mail Stop # 90
Los Angeles, CA 90027-6062

Mailing address

4650 W Sunset Blvd
Mail Stop # 90
Los Angeles, CA 90027-6062
Phone (323) 361-2178

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, HI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120725000486 CA Practitioner - Family PracticePractitioner - Pediatric MedicinePractitioner - Medical Genetics and Genomics 0042373201 Reassigns benefits to 3 organizations
I20240430003109 HI Practitioner - Medical Genetics and Genomics 0042373201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Medical Genetics and Genomics
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, shared by 4 NPIs, 11,250 clinicians

Practice addresses (Care Compare)

4700 W Sunset Blvd
Los Angeles, CA 90027-6082
Phone (323) 783-4011

4725 -4733 Sunset Blvd
Los Angeles, CA 90027-6021
Phone (323) 783-4011

4733 W Sunset Blvd
Los Angeles, CA 90027-6021
Phone (213) 667-4784

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
107303CAMDMarriage & Family Therapist
A107303CAMDClinical Biochemical Genetics Physician
R8236IAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 12, 2015 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 12, 2015 Accepting new patients
Hawaii Permanente Medical Group Inc CurrentSince Mar 6, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 12, 2015 Accepting new patients
Children'S Hospital Los Angeles Medical Group, Inc. CurrentSince Sep 1, 2012 Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3340

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

4650 W Sunset Blvd
Stop 90
Los Angeles, CA 90027
Phone (323) 361-2178

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

4760 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 783-0567

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000

711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312

2828 Paa St
Honolulu, HI 96819
Phone (808) 432-5700

3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205

Organizations & group practices 7

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": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1154515963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD",
            "address_2": "MAIL STOP # 90",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-2178",
            "fax_number": "323-361-1172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD",
            "address_2": "MAIL STOP # 90",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-2178",
            "fax_number": "323-361-1172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VATS",
        "first_name": "DIVYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-05",
        "last_updated": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IA",
            "license": "R8236",
            "primary": false
        },
        {
            "code": "207SG0202X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Biochemical Genetics",
            "state": "CA",
            "license": "A107303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4760 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.