Individual provider Active NPI

Pranay Bahuguna, M.D.

  • Hospitalist Physician
  • Fairfield, CA
National Provider Identifier
1174598932
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
C55727 Issued in CA
Practice address
3165 Cherry Valley Circle
Fairfield, CA 94534
Phone
(203) 583-2644
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 044190 CT
Hospitalist Physician 208M00000X C55727 CA Primary

Addresses

Primary practice location

3165 Cherry Valley Circle
Fairfield, CA 94534

Mailing address

3165 Cherry Valley Circle
Fairfield, CA 94534
Phone (203) 583-2644

Other identifiers 1

IdentifierTypeStateIssuer
001441906MedicaidCT

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
I20150731017190 CA Practitioner - Internal Medicine 9931110988 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Galen Inpatient Physicians PCGroup PAC ID 3678464633, 1,045 clinicians

Practice addresses (Care Compare)

726 4TH St
Marysville, CA 95901-5656
Phone (530) 749-4300

Hospital & facility affiliations

  • Adventist Health and Rideout Hospital, Marysville, CA, CCN 050133

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C55727CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Hospitalist CurrentSince Sep 1, 2023 Accepting new patients
Galen Inpatient Physicians PC Hospitalist CurrentSince Dec 1, 2022 Accepting new patients
Galen Inpatient Physicians Inc CurrentSince Dec 1, 2022 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Sep 1, 2023 Accepting new patients
Galen Inpatient Physicians, PC Hospitalist Current Accepting new patients
Alliance Medical Group of Greater Waterbury PC Hospitalist Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900

726 4th St
Marysville, CA 95901
Phone (530) 491-9491

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

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.

Hospital & facility affiliations 1

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1174598932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3165 CHERRY VALLEY CIRCLE",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "94534",
            "telephone_number": "203-583-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3165 CHERRY VALLEY CIRCLE",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "94534",
            "telephone_number": "203-583-2644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHUGUNA",
        "first_name": "PRANAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "044190",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "C55727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001441906",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.