Individual provider Active NPI

Christos G Bovetas, M.D.

  • Internal Medicine Physician
  • Corona, CA
National Provider Identifier
1487740262
Registry record updated Dec 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A82511 Issued in CA
Practice address
2250 S Main St Ste 106
Corona, CA 92882-2501
Phone
(951) 371-2703
Fax
(951) 371-9348
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2017

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 A82511 CA Primary

Addresses

Primary practice location

2250 S Main St Ste 106
Corona, CA 92882-2501

Mailing address

1901 Town and Country Dr Ste 104
Norco, CA 92860-3611
Phone (951) 808-6250

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
I20040413000639 CA Practitioner - Internal MedicinePractitioner - General Practice 2062406093 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: General Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Citrus Valley Medical Associates IncGroup PAC ID 0446329932, 14 clinicians

Practice addresses (Care Compare)

2250 S Main St
Suite 106
Corona, CA 92882-2501
Phone (951) 371-2703

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions17
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
82511CAMDClinical Social Worker
A82511CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Medical Center of Corona Inc. CurrentSince Dec 1, 2015 Accepting new patients
Citrus Valley Medical Associates, Inc. Internal Medicine CurrentSince May 1, 2008 Accepting new patients
Uhs Corona Inc Past Accepting new patients
Aliuddin Khaja, MD., Inc Past Accepting new patients
Pirritano Chiropractic Corporation PastSince Dec 1, 2015 Accepting new patients

Locations

2250 S Main St
Ste 106
Corona, CA 92882
Phone (951) 371-2703

2250 S Main St
Ste 203
Corona, CA 92882
Phone (800) 595-2447

1901 Town and Country Dr
Ste 104
Norco, CA 92860
Phone (951) 737-8141

940 N Haven Ave
Ste 18025
Ontario, CA 91764

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: chris.bovetas.p1@direct.cvma.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513555200000",
    "number": "1487740262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 TOWN AND COUNTRY DR STE 104",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "928603611",
            "telephone_number": "951-808-6250",
            "fax_number": "951-738-9954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 S MAIN ST STE 106",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928822501",
            "telephone_number": "951-371-2703",
            "fax_number": "951-371-9348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOVETAS",
        "first_name": "CHRISTOS",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2017-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A82511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.