NPIMap

Individual provider Active NPI

Parish Subhash Vaidya, MD

  • Physical Medicine & Rehabilitation Physician
  • Irvine, CA
National Provider Identifier
1205033594
Registry record updated Apr 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
A105629 Issued in CA
Practice address
15775 Laguna Canyon Rd
Suite 120
Irvine, CA 92618-3189
Phone
(949) 335-7411
NPI assigned
Jun 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X M6924 TX
Physical Medicine & Rehabilitation Physician 208100000X A105629 CA Primary

Addresses

Primary practice location

15775 Laguna Canyon Rd
Suite 120
Irvine, CA 92618-3189

Mailing address

92 Corporate Park
Suite C-330
Irvine, CA 92606-5146
Phone (949) 335-7411

Other identifiers 1

IdentifierTypeStateIssuer
187646801MedicaidTX

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
I20090306000353 CA Practitioner - Physical Medicine and RehabilitationPractitioner - Interventional Pain ManagementPractitioner - Pain Management 8921199803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Interventional Pain Management, Pain Management
Education
Temple University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
James Petros MD IncGroup PAC ID 0941479216, 21 clinicians

Practice addresses (Care Compare)

1604 Blossom Hill Rd
Suite 10
San Jose, CA 95124-6350
Phone (408) 528-8833

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A105629CAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Medical Group of California, Inc PastSince Sep 30, 2012 Accepting new patients
Santa Barbara Cottage Hospital Past Accepting new patients
CHI St. Luke'S Health Baylor College of Medicine Medical Center Past Accepting new patients
Harris County Hospital District Past Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients
Good Samaritan Hospital Ca LTD PTP Past Accepting new patients
Keith Mark Gross MD Inc Past Accepting new patients
Texas Children'S Hospital Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 9

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": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396396800000",
    "number": "1205033594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 CORPORATE PARK",
            "address_2": "SUITE C-330",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926065146",
            "telephone_number": "949-335-7411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15775 LAGUNA CANYON RD",
            "address_2": "SUITE 120",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183189",
            "telephone_number": "949-335-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAIDYA",
        "first_name": "PARISH",
        "middle_name": "SUBHASH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2014-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "M6924",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A105629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187646801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.