Individual provider Active NPI

Praveen Akuthota, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • San Diego, CA
National Provider Identifier
1396704698
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
C137976 Issued in CA
Practice address
4520 Executive Dr
San Diego, CA 92121-3018
Phone
(800) 926-8273
NPI assigned
Mar 23, 2006
Last updated
Jun 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 3

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

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, 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

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

Care Compare profile

Medicare Care Compare
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 CaliforniaGroup PAC ID 3577476761, shared by 18 NPIs, 2,047 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C137976CAMDPulmonary Disease Physician
218412MAMDPulmonary Disease Physician

Practice roles

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

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5720

4520 Executive Dr
San Diego, CA 92121
Phone 8584505900103

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

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

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "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": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "C137976",
            "primary": true
        },
        {
            "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
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.