Individual provider Active NPI

Sethu V. Madhavan, MD

  • Gastroenterology Physician
  • Lancaster, CA
National Provider Identifier
1194732230
Registry record updated May 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A38104 Issued in CA
Practice address
867 W Lancaster Blvd
Lancaster, CA 93534-2348
Phone
(661) 945-7181
Fax
(661) 942-6008
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A38104 CA Primary

Addresses

Primary practice location

867 W Lancaster Blvd
Lancaster, CA 93534-2348

Mailing address

9421 Oak Leaf Dr
Chatsworth, CA 91311-4700
Phone (661) 945-7181

Other identifiers 1

IdentifierTypeStateIssuer
00A381040MedicaidCA

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
I20031107000706 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 8820901671 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kern County Hospital Authority CurrentSince Nov 28, 2022 Accepting new patients
Kern County Hospital Authority CurrentSince Nov 28, 2022 Accepting new patients
Antelope Valley Health Care District Past Accepting new patients
Complete Family Care Medical Corp PastSince May 19, 2003 Accepting new patients
Lancaster Hospital Corporation Past Accepting new patients

Locations

1700 Mount Vernon Ave
Bakersfield, CA 93306
Phone (616) 326-2000

Organizations & group practices 5

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558483200000",
    "number": "1194732230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9421 OAK LEAF DR",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913114700",
            "telephone_number": "661-945-7181",
            "fax_number": "661-942-6008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "867 W LANCASTER BLVD",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342348",
            "telephone_number": "661-945-7181",
            "fax_number": "661-942-6008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADHAVAN",
        "first_name": "SETHU",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2019-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A38104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A381040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.