NPIMap

Individual provider Active NPI

Vishal Bansal, M.D.

  • Trauma Surgery Physician
  • San Diego, CA
National Provider Identifier
1194889410
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
A94958 Issued in CA
Practice address
550 Washington St Ste 641
San Diego, CA 92103-2229
Phone
(619) 298-3100
Fax
(619) 299-3923
NPI assigned
Dec 21, 2006
Last updated
Jan 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A94958 CA
Trauma Surgery Physician 2086S0127X A94958 CA Primary

Addresses

Primary practice location

550 Washington St Ste 641
San Diego, CA 92103-2229

Mailing address

550 Washington St Ste 641
San Diego, CA 92103-2229
Phone (619) 298-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070627000392 CA Practitioner - Critical Care (Intensivists)Practitioner - General SurgeryPractitioner - Other (Physician) 1355242058 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: General Surgery
Education
Wayne State University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trauma Team Medical Group IncorporatedGroup PAC ID 6002977642, 9 clinicians
On Call Specialists Medical Group of San Diego IncGroup PAC ID 7911395231, 145 clinicians

Practice addresses (Care Compare)

4077 5TH Ave
San Diego, CA 92103-2105
Phone (619) 298-3100

550 Washington St
San Diego, CA 92103-2232
Phone (619) 359-6600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A94958CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trauma Team Medical Group Incorporated CurrentSince Mar 1, 2015 Accepting new patients
Emergency and Acute Care Medical Corporation CurrentSince Aug 14, 2015 Accepting new patients
Scripps Health Trauma Surgery Current Accepting new patients
On Call Specialists Medical Group of San Diego, Inc. CurrentSince Jun 1, 2023 Accepting new patients
Community Family Health Centers Inc Past Accepting new patients
Pefha Health & Wellness Center Family Medicine Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

4077 5th Ave
San Diego, CA 92103
Phone (619) 260-7245

550 Washington St
Ste 641
San Diego, CA 92103
Phone (619) 298-3100

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

650 E Devon Ave
Ste 165
Itasca, IL 60143
Phone (630) 285-1040

Interoperability endpoints

  • Direct secure messaging: vbansal25845@scrippshlth.medalliesdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1194889410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 WASHINGTON ST STE 641",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032229",
            "telephone_number": "619-298-3100",
            "fax_number": "619-299-3923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 WASHINGTON ST STE 641",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032229",
            "telephone_number": "619-298-3100",
            "fax_number": "619-299-3923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANSAL",
        "first_name": "VISHAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A94958",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "CA",
            "license": "A94958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.