Madhavi Mummaneni, MD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

A52454 Issued in CA

Practice address

805 W la Veta Ave Ste 101
Orange, CA 92868-3928

Phone

(714) 628-3136

NPI assigned

May 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Hematology/OncologyAlso: Internal Medicine

Education

University of Southern California Keck School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St. Joseph Hospital Hospital, Orange, CA, CCN 050069

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: mmummaneni1372925@oc.providencedirect.org

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD (past)
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• Orange County Global Medical Center, Inc

  • General Acute Care Hospital
  • Santa Ana, CA
  • NPI 1982697678
  NPD (past)
• St Joseph Hospital of Orange

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1912982216
  NPD (past)
• Providence Health & Services - Wa

  • Skilled Nursing Facility
  • Chewelah, WA
  • NPI 1700038197
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Joseph Hospital of Orange

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1912982216
  Care Compare affiliation
• St. Joseph Hospital of Orange

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1558575746
  Care Compare affiliation

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1316999550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 W LA VETA AVE STE 101",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683928",
            "telephone_number": "714-835-1800",
            "fax_number": "714-835-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 W LA VETA AVE STE 101",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683928",
            "telephone_number": "714-628-3136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 W La Veta Ave",
            "address_2": "#200",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928684300",
            "country_code": "US",
            "telephone_number": "714-835-1800",
            "fax_number": "714-835-1811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUMMANENI",
        "first_name": "MADHAVI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A52454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A524540734",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPIN",
            "identifier": "WA52454A",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gage Austin Mulqueen
• Patrick Jason Mulroy, D.O.
• Pei Lily Mulroy, D.O.
• Rhea M Mulvina, NP-C
• Darlene Mulyanto-Mong
• Rubaina Mumtaz, C.HT
• Yovanna Mundo
• Alla Munger
• Gerardo Jr Munguia
• Dulce Muniz

• Hematology & Oncology Physician in Orange, CA
• Providers in Orange, CA by specialty
• Hematology & Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.