Individual provider Active NPI

Anil M Shivaram, M.D.

  • Ophthalmology Physician
  • Claremont, CA
National Provider Identifier
1346426293
Registry record updated Aug 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A102249 Issued in CA
Practice address
655 E Foothill Blvd
Claremont, CA 91711-3511
Phone
(909) 624-8077
NPI assigned
Jan 10, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A102249 CA Primary

Addresses

Primary practice location

655 E Foothill Blvd
Claremont, CA 91711-3511

Mailing address

655 E Foothill Blvd
Claremont, CA 91711-3511
Phone (909) 624-8077

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
I20080423000682 CA Practitioner - Ophthalmology 6901984467 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Yale University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Claremont Eye Associates Medical GroupGroup PAC ID 2961568464, 3 clinicians

Practice addresses (Care Compare)

655 E Foothill Blvd
Claremont, CA 91711-3511
Phone (909) 624-8077

Hospital & facility affiliations

  • Pomona Valley Hospital Medical Center Hospital, Pomona, CA, CCN 050231

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery424

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A102249CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Haven Eye Institute Inc Ophthalmology CurrentSince Jan 17, 2018 Accepting new patients
Pomona Valley Hospital Medical Center Ophthalmology PastSince Jan 1, 2009 Accepting new patients
Chino Medical Group, Inc Past Accepting new patients

Locations

840 Towne Center Dr
Pomona, CA 91767

9616 Archibald Ave
Ste 140
Rancho Cucamonga, CA 91730
Phone (909) 481-0436

9190 Haven Ave
Ste 200
Rancho Cucamonga, CA 91730
Phone (909) 481-0436

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344988800000",
    "number": "1346426293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 E FOOTHILL BLVD",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917113511",
            "telephone_number": "909-624-8077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 E FOOTHILL BLVD",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917113511",
            "telephone_number": "909-624-8077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVARAM",
        "first_name": "ANIL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-10",
        "last_updated": "2012-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A102249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremont, CA

Sources for this page

Verify at the official NPI Registry.