Vidyamohan Balu
Individual provider Active NPI Internal Medicine Physician · San Jacinto, CA
NPI 1265815880 · NPPES record last updated Nov 13, 2018
Key facts
- NPI
- 1265815880
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- A152595 (CA)
- Practice address
- 341 E Main St Ste 100
San Jacinto, CA 92583-4206 - Phone
- (951) 654-9367
- NPI assigned
- Jul 1, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- R and N Gupta MD Professional Corporation
Practice addresses (Care Compare)
341 E Main St
Suite 100
San Jacinto, CA 92583-4206
Phone (951) 654-9367
Hospital & facility affiliations
- Blue Sky Home Health, Inc
- Hemet Global Medical Center
- Hemet Hills Post Acute
- San Jacinto Valley Post Acute
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.73 of 100
- Quality
- 75.48
- Improvement activities
- 40
- Cost
- 75.12
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181203000944 | CA | Practitioner - Internal Medicine | 8921357112 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A152595 | CA | MD | Internal Medicine Physician |
Practice roles (3 of 4)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| R & N Gupta MD Professional Corporation | Internal Medicine | Current |
Accepting new patients |
| Hemet Valley Medical Center | Past | Accepting new patients | |
| Menifee Valley Medical Center | Past | Accepting new patients |
Locations
341 E Main St
Ste 100
San Jacinto, CA 92583
Phone (951) 654-5590
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A152595 | CA | Yes |
Addresses
Primary practice location
341 E Main St Ste 100
San Jacinto, CA 92583-4206
Mailing address
341 E Main St
Ste 100
San Jacinto, CA 92583-4206
Phone (951) 654-9367
Other providers in San Jacinto, CA
- Rita Awender
- B II Aj Our House, LLC
- Tami Bailey
- Giovanna Balboa
- Theresa Baldwin
- Ramjibhai H Baraiya
- Karla Joanna Barajas
- Susan Anne Barger
- Divyana Ramji Baria
- Lauren Jessica Barlow
All providers in San Jacinto, CA · Internal Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.