NPIMap

Individual provider Active NPI

Dinesh Raghunath Samant, MD

  • Cardiovascular Disease Physician
  • Covina, CA
National Provider Identifier
1417939596
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
34729 Issued in CA
Practice address
625 E Badillo St
Covina, CA 91723-2800
Phone
(626) 915-7300
Fax
(626) 967-8896
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 34729 CA Primary

Addresses

Primary practice location

625 E Badillo St
Covina, CA 91723-2800

Mailing address

625 E Badillo St
Covina, CA 91723-2800
Phone (626) 915-7300

Other identifiers 2

IdentifierTypeStateIssuer
060011957OtherCARR PTAN
ZZZ81401ZMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081027000563 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9739247347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grandview Medical Group IncGroup PAC ID 1456742485, 4 clinicians

Practice addresses (Care Compare)

625 E Badillo St
Covina, CA 91723-2800
Phone (626) 915-7300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34729CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grandview Medical Group, Inc. CurrentSince Dec 1, 2021 Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
San Dimas Community Hospital, Inc. Past Accepting new patients
Emanate Health Foothill Presbyterian Hospital Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients

Locations

625 E Badillo St
Covina, CA 91723
Phone (626) 915-7300

250 S Grand Ave
Glendora, CA 91741
Phone (626) 857-3118

1350 W Covina Blvd
San Dimas, CA 91773
Phone (909) 394-2745

1115 S Sunset Ave
West Covina, CA 91790
Phone (626) 814-2434

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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 6

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1417939596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 E BADILLO ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917232800",
            "telephone_number": "626-915-7300",
            "fax_number": "626-967-8896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 E BADILLO ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917232800",
            "telephone_number": "626-915-7300",
            "fax_number": "626-967-8896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMANT",
        "first_name": "DINESH",
        "middle_name": "RAGHUNATH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "34729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR PTAN",
            "identifier": "060011957",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ81401Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

Verify at the official NPI Registry.