NPIMap

Individual provider Active NPI

Ramani Nathan, MD

  • Nephrology Physician
  • Garden Grove, CA
National Provider Identifier
1487623724
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A26761 Issued in CA
Practice address
12665 Garden Grove Blvd Ste 211
Garden Grove, CA 92843-1916
Phone
(714) 636-2890
NPI assigned
Mar 17, 2006
Last updated
Nov 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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 A26761 CA Primary

Addresses

Primary practice location

12665 Garden Grove Blvd Ste 211
Garden Grove, CA 92843-1916

Mailing address

12665 Garden Grove Blvd Ste 211
Garden Grove, CA 92843-1916
Phone (714) 636-2890

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ75439ZMedicaidCA

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
I20120221000966 CA Practitioner - Nephrology 8224023189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1964
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Kidney Consultants IncGroup PAC ID 6103811286, 21 clinicians

Practice addresses (Care Compare)

12665 Garden Grove Blvd
Suite 211
Garden Grove, CA 92843-1916
Phone (714) 636-2890

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A26761CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Kidney Consultants Inc. Nephrology CurrentSince Jan 1, 1973 Accepting new patients
Chapman Medical Center Inc Past Accepting new patients
South Coast Global Medical Center, Inc Past Accepting new patients
University of California Irvine Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients

Locations

100 E Valencia Mesa Dr
Ste 100
Fullerton, CA 92835
Phone (714) 525-4185

100 E Valencia Mesa Dr
Ste 217
Fullerton, CA 92835
Phone (714) 525-7177

12665 Garden Grove Blvd
Ste 211
Garden Grove, CA 92843
Phone (714) 636-2890

5451 La Palma Ave
Ste 47
La Palma, CA 90623
Phone (714) 226-0818

1820 E Deere Ave
Santa Ana, CA 92705
Phone (949) 251-1221

721 W 1st St
Tustin, CA 92780
Phone (714) 544-0079

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21072/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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 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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1487623724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD STE 211",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431916",
            "telephone_number": "714-636-2890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD STE 211",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431916",
            "telephone_number": "714-636-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATHAN",
        "first_name": "RAMANI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A26761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ75439Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.