Organization Active NPI

Veena S Katikineni MD Inc a Professional Medical Corporation

  • Rheumatology Physician
  • Victorville, CA
National Provider Identifier
1376202887
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
Legal business name
VEENA S KATIKINENI MD INC A PROFESSIONAL MEDICAL CORPORATION
Practice address
12677 Hesperia Rd Ste 140
Victorville, CA 92395-7735
Phone
(442) 242-7334
Fax
(442) 242-7372
NPI assigned
Dec 12, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Janice D Hordge
Title
Billing Manager
Phone
(202) 351-3163

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RR0500X Primary

Addresses

Primary practice location

12677 Hesperia Rd Ste 140
Victorville, CA 92395-7735

Mailing address

12677 Hesperia Rd Ste 140
Victorville, CA 92395-7735
Phone (442) 242-7334

Other identifiers 1

IdentifierTypeStateIssuer
A172714OtherCACA LICENSE

Other names 1

  • VEENA S KATIKINENI MD INC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220427001978 CA Part B Supplier - Clinic/Group Practice 5092102772 Receives reassigned benefits from 1 practitioner
Practice locations: Victorville, CA

National Provider Directory

National Provider Directory

Locations

12677 Hesperia Rd
Victorville, CA 92395
Phone (607) 955-5656

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1639267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1376202887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12677 HESPERIA RD STE 140",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957735",
            "telephone_number": "442-242-7334",
            "fax_number": "442-242-7372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12677 HESPERIA RD STE 140",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957735",
            "telephone_number": "442-242-7334",
            "fax_number": "442-242-7372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VEENA S KATIKINENI MD INC A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-12",
        "last_updated": "2023-03-07",
        "certification_date": "2022-04-19",
        "status": "A",
        "authorized_official_last_name": "HORDGE",
        "authorized_official_first_name": "JANICE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "202-351-3163"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LICENSE",
            "identifier": "A172714",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VEENA S KATIKINENI MD INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.