Ravi Botla, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

J7912 Issued in TX

Practice address

621 Camden Street
Suite 202
San Antonio, TX 78215-1639

Phone

(210) 253-3422

Fax

(210) 227-9833

NPI assigned

Sep 20, 2006

Sex

Male

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 3

Medicare fee-for-service enrollment

Enrolled in TX, CA2 enrollments

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 2

Specialty

Gastroenterology

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph'S Medical Center of Stockton Hospital, Stockton, CA, CCN 050084
• Mark Twain Medical Center Hospital, San Andreas, CA, CCN 051332

Merit-based Incentive Payment System (MIPS)

Final score

80.98 of 100Reported as group

Quality

66.51

Promoting interoperability

98

Improvement activities

40

Cost

71.76

Merit-based Incentive Payment System (MIPS)

Final score

99.64 of 100Reported as apm

Quality

86.27

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1700803418
  Medicare reassignment Care Compare group NPD
• Texas Digestive Disease Consultants, PLLC

  • Gastroenterology Physician
  • Irving, TX
  • NPI 1053397331
  Medicare reassignment NPD
• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Redding, CA
  • NPI 1912288432
  NPD
• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Stockton, CA
  • NPI 1861410581
  NPD (past)

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

• Mark Twain Medical Center

  • Critical Access Hospital
  • San Andreas, CA
  • NPI 1508968819
  Care Compare affiliation
• Port City Operating Company, LLC

  • General Acute Care Hospital
  • Stockton, CA
  • NPI 1528190931
  Care Compare affiliation

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487721600000",
    "number": "1366540544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 75235",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752350629",
            "telephone_number": "214-424-2200",
            "fax_number": "214-231-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 CAMDEN STREET",
            "address_2": "SUITE 202",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782151639",
            "telephone_number": "210-253-3422",
            "fax_number": "210-227-9833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTLA",
        "first_name": "RAVI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2017-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "J7912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - RAILROAD",
            "identifier": "930072561",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136549604",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "87500S",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adriana Botero, LPC, LCDC
• Maria Iuliana Botez, MD
• Terra A Botha, D.C.
• Catherine Anne Bothwell, M.S.,CCC-SLP
• Nici Eddy Bothwell, MD
• Vijaya Botla, RDN, LD
• Sylvia M. Botros-Brey, MD
• Mina Botros, DDS
• Jonathan E Botrous
• Andrew Bott, DDS

• Gastroenterology Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Gastroenterology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; 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.