Vaishali Benaka Hebbar, MD
Individual provider Active NPI Pediatrics Physician · Patterson, CA
NPI 1275821001 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1275821001
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- A129252 (CA)
- Practice address
- 200 C St
Patterson, CA 95363-2701 - Phone
- (209) 892-8441
- Fax
- (209) 892-5984
- NPI assigned
- Jul 14, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
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 |
|---|---|---|---|---|
| I20170816001084 | CA | Practitioner - Pediatric Medicine | 8426320177 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A129252 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Medical Centers Inc | Current |
Accepting new patients | |
| Community Medical Centers, Inc. | Current | Accepting new patients | |
| Community Medical Centers Inc | Current |
Accepting new patients |
Locations
7210 Murray Dr
Stockton, CA 95210
Phone (209) 373-2816
730 N Central Ave
Tracy, CA 95376
Phone (209) 820-1500
2151 W Grant Line Rd
Tracy, CA 95377
Phone (209) 820-1500
Interoperability endpoints
- vaishali.benakahebbar.p1@direct.cmcentersinc.nextgenshare.com
- vbenakahebbar761565@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | A129252 | CA | Yes |
Addresses
Primary practice location
200 C St
Patterson, CA 95363-2701
Mailing address
737 W Childs Ave
Merced, CA 95341-6805
Phone (209) 384-6488
Other practice location 1
1000 W Carson St
Box 491
Torrance, CA 90502-2004
Phone (310) 222-4002
Other providers in Patterson, CA
- Janet Avina
- Tomas Ayala Jr.
- Fatema Bandookwala
- Isabel Barboza
- Lizandro Barragan
- Paul S. Berry
- Bailey Marie Bielecki
- Victoire O Bongwele
- William Thomas Bragdon Jr.
- Harpreet Brar
All providers in Patterson, CA · Pediatrics 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 Jul 21, 2022. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.