NPIMap

Praveen Akuthota, M.D.

Individual provider Active NPI Critical Care Medicine (Internal Medicine) Physician · San Diego, CA

NPI 1396704698 · NPPES record last updated Jun 26, 2024

Key facts

NPI
1396704698
Entity type
Individual (NPI type 1)
Primary specialty
Critical Care Medicine (Internal Medicine) Physician 207RC0200X
License
C137976 (CA)
Practice address
4520 Executive Dr
San Diego, CA 92121-3018
Phone
(800) 926-8273
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 25

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.

Medicare Care Compare profile

Specialty
Critical Care (Intensivists)
Also: Pulmonary Disease
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the University of California (2,047 clinicians)

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (858) 249-6753

Hospital & facility affiliations

  • UC San Diego Health Hillcrest - Hillcrest Med Ctr Hospital · San Diego, CA · CCN 050025

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MA, CA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20051205000215 MA Practitioner - Pulmonary Disease
Practitioner - Critical Care (Intensivists)		 8527088699 Reassigns benefits to 1 organization
I20150930000369 CA Practitioner - Critical Care (Intensivists)
Practitioner - Pulmonary Disease
Practitioner - Internal Medicine		 8527088699 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C137976CAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California - Ucsd Medical Group Current
since Sep 1, 2015		 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Current
since Jun 14, 2009		 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Current
since Jun 14, 2009		 Accepting new patients
Regents of the University of California Pulmonary Disease Current
since Sep 1, 2015		 Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California Current
since Sep 1, 2015		 Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients
North Shore Pulmonary Associates, Inc Pulmonary Disease Past
since Dec 5, 2007		 Accepting new patients
Regents of the University of California Past Accepting new patients
Mass General Brigham Medical Group Northern Massachusetts Inc Pulmonary Disease Past
since Feb 1, 2016		 Accepting new patients

Locations

9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000

File 57326
Los Angeles, CA 90074

35900 Bob Hope Dr
Ste 257
Rancho Mirage, CA 92270
Phone (760) 321-2500

4520 Executive Dr
Ste P2
San Diego, CA 92121
Phone (844) 757-5337

4520 Executive Dr
San Diego, CA 92121
Phone (858) 249-1429

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

330 Brookline Ave
#4
Boston, MA 02215
Phone (617) 667-1282

1 University Ave
Westwood, MA 02090
Phone (617) 754-1021

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 218412 MA
Pulmonary Disease Physician 207RP1001X C137976 CA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X C137976 CA Yes

Addresses

Primary practice location

4520 Executive Dr
San Diego, CA 92121-3018

Mailing address

File 57326
Los Angeles, CA 90074-7326
Phone (800) 926-8273

Other practice location 1

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (800) 926-8273

Other practice location 2

9300 Campus Point Dr
LA Jolla, CA 92037-1300
Phone (800) 926-8273

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 26, 2024.

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1396704698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 57326",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900747326",
            "telephone_number": "800-926-8273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 EXECUTIVE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213018",
            "telephone_number": "800-926-8273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W Arbor Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921039000",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9300 Campus Point Dr",
            "address_purpose": "LOCATION",
            "city": "LA Jolla",
            "state": "CA",
            "postal_code": "920371300",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AKUTHOTA",
        "first_name": "PRAVEEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MA",
            "license": "218412",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "C137976",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "C137976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

All providers in San Diego, CA · Critical Care Medicine (Internal Medicine) Physician in California

Sources for this page

Verify at the official NPI Registry.