NPIMap

Individual provider Active NPI

Pranav Sandilya Garimella, M.D.

  • Nephrology Physician
  • La Jolla, CA
National Provider Identifier
1477880102
Registry record updated Apr 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A143549 Issued in CA
Practice address
9452 Medical Center Dr # Mc7424
La Jolla, CA 92037-1337
Phone
(617) 636-8425
Fax
(617) 636-8329
NPI assigned
Nov 17, 2009
Last updated
Apr 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A143549 CA Primary

Addresses

Primary practice location

9452 Medical Center Dr # Mc7424
La Jolla, CA 92037-1337

Mailing address

9452 Medical Center Dr # Mc7424
La Jolla, CA 92037-1337
Phone (582) 463-2948

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
I20160914001743 CA Practitioner - Nephrology 4981824604 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

9350 Campus Point Dr
La Jolla, CA 92037-1300
Phone (858) 657-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A143549CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Nephrology CurrentSince Jul 19, 2016 Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California - Ucsd Medical Group Current Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California CurrentSince Jul 19, 2016 Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California Current Accepting new patients
Tufts Medical Center, Inc. Past Accepting new patients
Regents of the University of California Past Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Locations

9350 Campus Point Dr
La Jolla, CA 92037
Phone (858) 657-0583

9452 Medical Center Dr
#7424
La Jolla, CA 92037
Phone (617) 636-8425

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5720

4168 Front St
San Diego, CA 92103
Phone (619) 471-0420

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 2

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": "1258416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1477880102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9452 MEDICAL CENTER DR # MC7424",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371337",
            "telephone_number": "582-463-2948",
            "fax_number": "585-527-5498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9452 MEDICAL CENTER DR # MC7424",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371337",
            "telephone_number": "617-636-8425",
            "fax_number": "617-636-8329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARIMELLA",
        "first_name": "PRANAV",
        "middle_name": "SANDILYA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-17",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A143549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.