Individual provider Active NPI

Vani Krishna

  • Pediatrics Physician
  • Loma Linda, CA
National Provider Identifier
1285293191
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A193594 Issued in CA
Practice address
25845 Barton Rd
Loma Linda, CA 92354-3899
Phone
(909) 558-2828
NPI assigned
Jun 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 125074630 IL
Pediatrics Physician 208000000X A193594 CA Primary

Addresses

Primary practice location

25845 Barton Rd
Loma Linda, CA 92354-3899

Mailing address

25845 Barton Rd
Loma Linda, CA 92354-3899
Phone (909) 558-2828

Other practice location 1

400 N 9th St Fl 4
Springfield, IL 62702-5310
Phone (217) 545-8000

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240614000709 CA Practitioner - Pediatric Medicine 5092040758 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A193594CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sac Health System CurrentSince Jun 30, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Pediatrics CurrentSince Jul 16, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Sac Health System Current Accepting new patients
Sac Health System CurrentSince Jun 30, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients

Locations

82934 Civic Center Dr
Indio, CA 92201
Phone (760) 477-0733

11370 Anderson St
Ste 2600
Loma Linda, CA 92354
Phone (909) 558-2890

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146

2195 Club Center Dr
Ste A
Sn Bernrdno, CA 92408
Phone (909) 835-1750

Interoperability endpoints

  • Direct secure messaging: vkrishna1191561@direct.llu.edu

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1285293191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25845 BARTON RD",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543899",
            "telephone_number": "909-558-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25845 BARTON RD",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543899",
            "telephone_number": "909-558-2828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 N 9th St Fl 4",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627025310",
            "country_code": "US",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-4779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRISHNA",
        "first_name": "VANI",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-13",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125074630",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A193594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.