Individual provider Active NPI

Shaunak Vijay Rana, M.D.

  • Nephrology Physician
  • San Diego, CA
National Provider Identifier
1205046182
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A117404 Issued in CA
Practice address
1804 Garnet Ave
#721
San Diego, CA 92109-3352
Phone
(312) 863-9100
NPI assigned
May 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 036.117500 IL
Internal Medicine Physician 207R00000X A117404 CA
Hospitalist Physician 208M00000X A117404 CA
Nephrology Physician 207RN0300X A117404 CA Primary

Addresses

Primary practice location

1804 Garnet Ave
#721
San Diego, CA 92109-3352

Mailing address

1804 Garnet Ave
#721
San Diego, CA 92109-3352
Phone (619) 740-6000

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
I20131028001862 CA Practitioner - Internal MedicinePractitioner - Nephrology 5294992525 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
117404CAMDSocial Worker
036.117500ILMDNephrology Physician
A117404CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monica Perlman MD Inc. Family Medicine CurrentSince Jul 23, 2020 Accepting new patients
Stem Medical Group, PC CurrentSince Dec 8, 2022 Accepting new patients
UC Regents Current Accepting new patients
UC Regents Nephrology CurrentSince Sep 1, 2018 Accepting new patients
UC Regents CurrentSince Sep 1, 2018 Accepting new patients
UC San Diego Health - Rancho Family Medical Group Past Accepting new patients
Regents of the University of California Past Accepting new patients
Grossmont Hospital Corporation Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

1905 Calle Barcelona
Ste 211
Carlsbad, CA 92009
Phone (858) 766-6007

9850 Genesee Ave
Ste 320
La Jolla, CA 92037
Phone (858) 864-9800

7855 Ivanhoe Ave
Ste 110
La Jolla, CA 92037
Phone (858) 869-0188

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

3737 Moraga Ave
Ste B103
San Diego, CA 92117
Phone (858) 799-0855

3900 5th Ave
Ste 110
San Diego, CA 92103
Phone (619) 291-5474

501 S Cherry St
Ste 1100
Denver, CO 80246
Phone (404) 227-4864

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 10

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1205046182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 GARNET AVE",
            "address_2": "#721",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921093352",
            "telephone_number": "619-740-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 GARNET AVE",
            "address_2": "#721",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921093352",
            "telephone_number": "312-863-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANA",
        "first_name": "SHAUNAK",
        "middle_name": "VIJAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036.117500",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A117404",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A117404",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A117404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.