NPIMap

Organization Active NPI

California Institute of Cosmetic & Reconstructive Surgery a Medical Co

  • Plastic and Reconstructive Surgery Physician
  • Bakersfield, CA
National Provider Identifier
1396921797
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
A63639 Issued in CA
Legal business name
CALIFORNIA INSTITUTE OF COSMETIC & RECONSTRUCTIVE SURGERY A MEDICAL CO
Practice address
2901 Sillect Ave
Suite 201
Bakersfield, CA 93308-6371
Phone
(661) 327-2101
Fax
(661) 327-2554
NPI assigned
Jan 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

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

Authorized official

Name
Dr. Vipul Ramen Dev, M.D.NPI 1891702122
Title
Owner
Phone
(661) 327-2101

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X A63639 CA Primary

Addresses

Primary practice location

2901 Sillect Ave
Suite 201
Bakersfield, CA 93308-6371

Mailing address

2901 Sillect Ave
Suite 201
Bakersfield, CA 93308-6371
Phone (661) 327-2101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090203000116 CA Part B Supplier - Clinic/Group Practice 2567484488 Receives reassigned benefits from 5 practitioners
Practice locations: Bakersfield, CA
O20191111002786 CA DME Supplier - Physician - Plastic and Reconstructive Surgery 2567484488 Practice locations: Bakersfield, CA

National Provider Directory

National Provider Directory
Tax ID family
Gameday Sports Medicine Academy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

23929 McBean Pkwy
Ste 110
Valencia, CA 91355
Phone (661) 200-1710

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1200355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591920000000",
    "number": "1396921797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 SILLECT AVE",
            "address_2": "SUITE 201",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933086371",
            "telephone_number": "661-327-2101",
            "fax_number": "661-327-2554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 SILLECT AVE",
            "address_2": "SUITE 201",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933086371",
            "telephone_number": "661-327-2101",
            "fax_number": "661-327-2554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA INSTITUTE OF COSMETIC & RECONSTRUCTIVE SURGERY A MEDICAL CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-15",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A",
        "authorized_official_last_name": "DEV",
        "authorized_official_first_name": "VIPUL",
        "authorized_official_middle_name": "RAMEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "661-327-2101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A63639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; 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.