NPIMap

Individual provider Active NPI

Ravindranath Vishnu Shahane, M.D.

  • Internal Medicine Physician
  • Rialto, CA
National Provider Identifier
1457420903
Registry record updated Sep 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A87056 Issued in CA
Practice address
1734 N Riverside Ave
Suite #2
Rialto, CA 92376-8058
Phone
(909) 875-3595
Fax
(909) 875-1029
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A87056 CA Primary

Addresses

Primary practice location

1734 N Riverside Ave
Suite #2
Rialto, CA 92376-8058

Mailing address

1734 N Riverside Ave
Suite #2
Rialto, CA 92376-8058
Phone (909) 875-3595

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
I20041227000141 CA Practitioner - Internal Medicine 5294793147 Reassigns benefits to 1 organization
Practice locations: Rialto, CA

Care Compare profile

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

Practice addresses (Care Compare)

1734 N Riverside Ave
Suite 2
Rialto, CA 92376-8058
Phone (626) 608-6706

Hospital & facility affiliations

  • Holy Angel Home Health Care, Inc Home health agency, Los Angeles, CA, CCN 058259
  • Everest Peak Home Healthcare Home health agency, North Hollywood, CA, CCN 757697
  • Grand Terrace Hospice Hospice, Grand Terrace, CA, CCN 751748

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
87056CAMDDental Assistant
A87056CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sun C Soung,M.D.,Inc Current Accepting new patients
Ghasan M Tabel MD Inc Internal Medicine CurrentSince Oct 1, 2010 Accepting new patients
Desert Heart Physicians Medical Group, Inc. Past Accepting new patients
Dignity Health Past Accepting new patients
Adnan Misellati, M.D., Inc Past Accepting new patients
Community Hospital of San Bernardino Past Accepting new patients

Locations

160 W Foothill Pkwy
#105348
Corona, CA 92882
Phone (951) 374-0025

1734 N Riverside Ave
Ste 2
Rialto, CA 92376
Phone (909) 875-3595

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AIDBDD/Endpoint/AIDBDD

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Advantage Hospice Providers, Inc.Upland, CA, CCN 751556 Hospice Contracted Managing Employee Jan 12, 2024
Grand Terrace HospiceGrand Terrace, CA, CCN 751748 Hospice Contracted Managing Employee Apr 1, 2018

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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 3

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411257600000",
    "number": "1457420903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1734 N RIVERSIDE AVE",
            "address_2": "SUITE #2",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923768058",
            "telephone_number": "909-875-3595",
            "fax_number": "909-875-1029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1734 N RIVERSIDE AVE",
            "address_2": "SUITE #2",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923768058",
            "telephone_number": "909-875-3595",
            "fax_number": "909-875-1029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHANE",
        "first_name": "RAVINDRANATH",
        "middle_name": "VISHNU",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2014-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A87056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rialto, CA

Sources for this page

Verify at the official NPI Registry.