NPIMap

Organization Active NPI

Krishna Das MD Inc.

  • Diagnostic Radiology Physician
  • Victorville, CA
National Provider Identifier
1164284196
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
KRISHNA DAS MD INC.
Practice address
13010 Hesperia Rd
Victorville, CA 92395-5837
Phone
(760) 728-1900
NPI assigned
Jan 25, 2024
Last updated
Feb 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Authorized official

Name
Krishna DasNPI 1972820660
Title
MD
Phone
(914) 474-0495

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary

Addresses

Primary practice location

13010 Hesperia Rd
Victorville, CA 92395-5837

Mailing address

PO Box 3134
Indianapolis, IN 46206-3134
Phone (760) 728-1900

Other practice location 1

12490 Business Center Dr Ste 200
Victorville, CA 92395-5833
Phone (760) 728-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, IL, NY, MI, WA, NV, TX, VA8 enrollments

Enrollment records 8

Enrollment IDStateProvider typePAC IDDetails
O20240320000354 CA Part B Supplier - Clinic/Group Practice 3971940479 Receives reassigned benefits from 24 practitioners
Practice locations: Manhattan Beach, CA; Newport Beach, CA; North Tustin, CA; Rancho Cucamonga, CA; Redlands, CA; San Diego, CA; San Luis Obispo, CA; Scotts Valley, CA…
O20240326000884 IL Part B Supplier - Clinic/Group Practice 3971940479 Receives reassigned benefits from 2 practitioners
Practice locations: Cahokia Heights, IL; Carlinville, IL; Hillsboro, IL; Round Lake Beach, IL; Salem, IL; Woodstock, IL
O20240429001239 NY Part B Supplier - Clinic/Group Practice 3971940479 Receives reassigned benefits from 3 practitioners
Practice locations: Poughkeepsie, NY; New York, NY
O20241030001365 MI Part B Supplier - Clinic/Group Practice 3971940479 Receives reassigned benefits from 1 practitioner
Practice locations: Birmingham, MI
O20241217003850 WA Part B Supplier - Clinic/Group Practice 3971940479 Receives reassigned benefits from 1 practitioner
Practice locations: Seattle, WA
O20241217003905 NV Part B Supplier - Clinic/Group Practice 3971940479 Receives reassigned benefits from 2 practitioners
Practice locations: Las Vegas, NV
O20260127004531 TX Part B Supplier - Clinic/Group Practice 3971940479 Receives reassigned benefits from 1 practitioner
Practice locations: Southlake, TX
O20260515000478 VA Part B Supplier - Clinic/Group Practice 3971940479 Receives reassigned benefits from 2 practitioners
Practice locations: Glen Allen, VA; Lynchburg, VA

National Provider Directory

National Provider Directory

Locations

13010 Hesperia Rd
Victorville, CA 92395

Practitioners & affiliated clinicians

Practitioners 53

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.

View all 53

NPI Registry JSON

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

{
    "created_epoch": "1706140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706745600000",
    "number": "1164284196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3134",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462063134",
            "telephone_number": "760-728-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13010 HESPERIA RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955837",
            "telephone_number": "760-728-1900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12490 Business Center Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Victorville",
            "state": "CA",
            "postal_code": "923955833",
            "country_code": "US",
            "telephone_number": "760-728-1900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KRISHNA DAS MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-25",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A",
        "authorized_official_last_name": "DAS",
        "authorized_official_first_name": "KRISHNA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "914-474-0495"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.