Individual provider Active NPI

Bhargavesh Gottam, MD

  • Emergency Medicine Physician
  • Orange, CA
National Provider Identifier
1245805373
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A195524 Issued in CA
Practice address
101 The City Dr S
Orange, CA 92868-3201
Phone
(714) 456-8888
NPI assigned
May 21, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A195524 CA Primary

Addresses

Primary practice location

101 The City Dr S
Orange, CA 92868-3201

Mailing address

200 S Manchester Ave Ste 300
Orange, CA 92868-3219
Phone (469) 499-6731

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240520000630 CA Practitioner - Emergency Medicine 2567866205 Reassigns benefits to 1 organization
I20250815001460 TX Practitioner - Emergency Medicine 2567866205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Texas Tech University Health Science Center School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Century Integrated Partners, IncGroup PAC ID 6406151703, 330 clinicians

Practice addresses (Care Compare)

1400 8TH Ave
Fort Worth, TX 76104-4110
Phone (817) 926-2544

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A195524CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Century Integrated Partners, Inc Emergency Medicine CurrentSince Aug 1, 2025 Accepting new patients
Regents of the University of Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
University of California Irvine Past Accepting new patients

Locations

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

3500 Gaston Ave
Dallas, TX 75246

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

4700 Alliance Blvd
#P
Plano, TX 75093
Phone (469) 814-2000

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1245805373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S MANCHESTER AVE STE 300",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683219",
            "telephone_number": "469-499-6731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTAM",
        "first_name": "BHARGAVESH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-21",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A195524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.