Individual provider Active NPI

Vijaykumar Ramchandra Kini, MD

  • Radiation Oncology Physician
  • Tustin, CA
National Provider Identifier
1417940198
Registry record updated May 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
A84739 Issued in CA
Practice address
2895 Edinger Ave
Tustin, CA 92780-7257
Phone
(949) 381-5800
Fax
(949) 552-5152
NPI assigned
Aug 26, 2005
Last updated
May 2, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X A84739 CA Primary

Addresses

Primary practice location

2895 Edinger Ave
Tustin, CA 92780-7257

Mailing address

PO Box 101455
Pasadena, CA 91189-1455
Phone (949) 381-5800

Other identifiers 1

IdentifierTypeStateIssuer
00A847390MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20031121000888 CA Practitioner - Radiation Oncology 1052215993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2895 Edinger Ave
Tustin, CA 92780-7257
Phone (949) 381-5800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A84739CAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vijay Kini MD. Inc. Radiation Oncology CurrentSince Nov 1, 2005 Accepting new patients
Woodhouse & Karon, a Medical Corporation Radiation Oncology Current Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients
Valley Radiotherapy Associates Medical Group Inc Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
University of California Irvine Past Accepting new patients
MCV Associated Physicians Radiation Oncology PastSince Aug 1, 2017 Accepting new patients

Locations

1211 W La Palma Ave
Anaheim, CA 92801
Phone (714) 288-8887

1211 W La Palma Ave
Ste 100
Anaheim, CA 92801
Phone (714) 956-1686

1211 W La Palma Ave
Ste 709
Anaheim, CA 92801
Phone (714) 808-9292

11190 Warner Ave
Ste 115
Fountain Vly, CA 92708
Phone (714) 210-0140

1605 Avocado Ave
Newport Beach, CA 92660
Phone (949) 760-3025

1301 N Rose Dr
Placentia, CA 92870
Phone (714) 524-4252

2895 Edinger Ave
Tustin, CA 92780
Phone (714) 776-7090

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, 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": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493683200000",
    "number": "1417940198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 101455",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911891455",
            "telephone_number": "949-381-5800",
            "fax_number": "949-552-5152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2895 EDINGER AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807257",
            "telephone_number": "949-381-5800",
            "fax_number": "949-552-5152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINI",
        "first_name": "VIJAYKUMAR",
        "middle_name": "RAMCHANDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2017-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "A84739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A847390",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.