Active NPI
C S Dushyant Mukkamala Venkata, MD, PHD
- Pediatrics Physician
- Hanford, CA
National Provider Identifier
1285297747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 186873
- Practice address
- 250 W 5TH St
Hanford, CA 93230-5029 - Phone
- (877) 960-3426
- NPI assigned
- Apr 19, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Endocrinology Physician | 2080P0205X | 71875 | CT | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 186873 | CA | Primary |
Addresses
Primary practice location
250 W 5TH St
Hanford, CA 93230-5029
Mailing address
305 E Center Ave
Visalia, CA 93291-6331
Phone (559) 737-4775
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 186873 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Healthcare Network | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Federally Qualified Health Center (FQHC)
- Ivanhoe, CA
- NPI 1386670610
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737676800000",
"number": "1285297747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 E CENTER AVE",
"city": "VISALIA",
"state": "CA",
"postal_code": "932916331",
"telephone_number": "559-737-4775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 W 5TH ST",
"city": "HANFORD",
"state": "CA",
"postal_code": "932305029",
"telephone_number": "877-960-3426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUKKAMALA VENKATA",
"first_name": "C S DUSHYANT",
"name_prefix": "Dr.",
"credential": "MD, PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-04-19",
"last_updated": "2025-01-24",
"certification_date": "2025-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0205X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Endocrinology",
"state": "CT",
"license": "71875",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "186873",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hanford, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.