Active NPI
Prashant Vasant Phatak, M.D.
- Hospitalist Physician
- Loma Linda, CA
National Provider Identifier
1205845096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- A74099
- Practice address
- VA Loma Linda
11201 Benton St, Dept 111H
Loma Linda, CA 92357-0001 - Phone
- (909) 825-7084
- NPI assigned
- Aug 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | A74099 | CA | Primary |
Addresses
Primary practice location
VA Loma Linda
11201 Benton St, Dept 111H
Loma Linda, CA 92357-0001
Mailing address
VA Loma Linda
11201 Benton St, Dept 111H
Loma Linda, CA 92357-0001
Phone (909) 825-7084
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130423000368 | CA | Order and Referring Only - Internal Medicine | 6305082157 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A74099 | CA | MD | Hospitalist Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746662400000",
"number": "1205845096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "VA LOMA LINDA",
"address_2": "11201 BENTON ST, DEPT 111H",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923570001",
"telephone_number": "909-825-7084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "VA LOMA LINDA",
"address_2": "11201 BENTON ST, DEPT 111H",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923570001",
"telephone_number": "909-825-7084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHATAK",
"first_name": "PRASHANT",
"middle_name": "VASANT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-08",
"last_updated": "2025-05-08",
"certification_date": "2025-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "CA",
"license": "A74099",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loma Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.