Siddhartha Agrawal, M.D.
Individual provider Active NPI Nephrology Physician · Visalia, CA
NPI 1477761963 · NPPES record last updated Dec 2, 2024
Key facts
- NPI
- 1477761963
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nephrology Physician 207RN0300X
- License
- A102877 (CA)
- Practice address
- 820 S Akers St Ste 100
Visalia, CA 93277-8306 - Phone
- (559) 625-4118
- Fax
- (559) 625-6004
- NPI assigned
- May 18, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 18
Medicare Care Compare profile
- Specialty
- Nephrology
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bass Medical Group
South Valley Vascular Associates Inc.
Practice addresses (Care Compare)
365 Lennon LN
Walnut Creek, CA 94598-5915
384 Pearson Dr
Porterville, CA 93257-3368
Phone (559) 625-4118
820 S Akers St
Visalia, CA 93277-8306
Phone (559) 625-4118
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.98 of 100
- Quality
- 80.39
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Varicose vein removal | 56 |
| Leg revascularization (restoring blood flow) | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090819000245 | CA | Practitioner - Nephrology |
7214081645 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A102877 | CA | MD | Nephrology Physician |
Practice roles (8 of 9)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bass Medical Group | Current | Accepting new patients | |
| South Valley Vascular Associates Inc. | Current |
Accepting new patients | |
| Bass Medical Group | Current |
Accepting new patients | |
| Bass Medical Group | Current |
Accepting new patients | |
| Saint Agnes Medical Center | Past | Accepting new patients | |
| Bass Medical Group | Past | Accepting new patients | |
| Juergen P. Krauthammer, MD, Inc | Past |
Accepting new patients | |
| Bass Medical Group | Past | Accepting new patients |
Locations
1646 E Herndon Ave
Ste 106
Fresno, CA 93720
Phone (559) 490-0234
7045 N Maple Ave
Ste 107
Fresno, CA 93720
7014 N Whitney Ave
Fresno, CA 93720
Phone (559) 321-2800
7045 N Maple Ave
Ste 108
Fresno, CA 93720
Phone (559) 326-7393
384 Pearson Dr
Porterville, CA 93257
Phone (559) 781-5179
820 S Akers St
Ste 120
Visalia, CA 93277
Phone (559) 625-9601
820 S Akers St
Ste 100
Visalia, CA 93277
Phone (559) 624-6800
365 Lennon Ln
Ste 250
Walnut Creek, CA 94598
Phone (925) 627-3424
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- siddhartha.agrawal@bass.eclinicaldirectplus.com
- https://fhir4.healow.com/fhir/r4/IBDGCA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | A102877 | CA | Yes |
Addresses
Primary practice location
820 S Akers St Ste 100
Visalia, CA 93277-8306
Mailing address
820 S Akers St Ste 100
Visalia, CA 93277-8306
Other providers in Visalia, CA
- Adventist Health Physicians Network
- Adventist Health Physicians Network
- Adventist Health Physicians Network
- Adventist Health Physicians Network
- Adventist Health Physicians Network
- Ana Isabel Aguayo
- Jaime C Aguet
- Alexandra Marie Aguila
- Emily Susana Aguilar-Gutierrez
- Adriana G Aguilar
All providers in Visalia, CA · Nephrology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.