NPIMap

Organization Active NPI

Simi San Fernando Valley Urology Associates

  • Specialist
  • Mission Hills, CA
National Provider Identifier
1275633695
Registry record updated Jan 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A37982 Issued in CA
Legal business name
SIMI SAN FERNANDO VALLEY UROLOGY ASSOCIATES
Practice address
14901 Rinaldi St
Suite 205
Mission Hills, CA 91345-1204
Phone
(818) 365-0259
Fax
(805) 365-0827
NPI assigned
Sep 25, 2006
Last updated
Jan 20, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2009

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

Authorized official

Name
Dr. Muni Nanjunda Reddy, MDNPI 1295705606
Title
Sr. Partner
Phone
(818) 365-0259

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A37982 CA Primary

Addresses

Primary practice location

14901 Rinaldi St
Suite 205
Mission Hills, CA 91345-1204

Mailing address

14901 Rinaldi St
Suite 205
Mission Hills, CA 91345-1204
Phone (818) 365-0259

Other identifiers 1

IdentifierTypeStateIssuer
00A379820MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040324001664 CA Part B Supplier - Clinic/Group Practice 6507757796 Receives reassigned benefits from 4 practitioners
Practice locations: Simi Valley, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0948535Simi-San Fernando Valley Urology Assoc14901 Rinaldi Street Suite 205, Mission Hills, CA 91345Certificate of waiverJul 12, 2028

National Provider Directory

National Provider Directory
Tax ID family
Simi San Fernando Valley Urology Associates4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

16661 Ventura Blvd
Ste 310
Encino, CA 91436
Phone (805) 306-8800

14901 Rinaldi St
Ste 205
Mission Hills, CA 91345
Phone (818) 365-0259

2925 Sycamore Dr
Ste 103
Simi Valley, CA 93065
Phone (805) 583-0944

14124 Foothill Blvd
Ste 200
Sylmar, CA 91342
Phone (818) 367-1012

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232409600000",
    "number": "1275633695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14901 RINALDI ST",
            "address_2": "SUITE 205",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451204",
            "telephone_number": "818-365-0259",
            "fax_number": "805-365-0827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14901 RINALDI ST",
            "address_2": "SUITE 205",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451204",
            "telephone_number": "818-365-0259",
            "fax_number": "805-365-0827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMI SAN FERNANDO VALLEY UROLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2009-01-20",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "MUNI",
        "authorized_official_middle_name": "NANJUNDA",
        "authorized_official_title_or_position": "SR. PARTNER",
        "authorized_official_telephone_number": "818-365-0259",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A37982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A379820",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.