Bhanu P Wunnava, MBBS

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

201695 Issued in LA

Practice address

4864 Jackson St
Department of Family Medicine
Monroe, LA 71202-6400

Phone

(318) 330-7626

Fax

(318) 330-7648

NPI assigned

May 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Family Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

San Joaquin Faculty Medical GroupGroup PAC ID 4082631395, 126 clinicians

County of San JoaquinGroup PAC ID 6002703436, 199 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Joaquin General Hospital Hospital, French Camp, CA, CCN 050167
• St Joseph's Medical Center of Stockton Hospital, Stockton, CA, CCN 050084

Merit-based Incentive Payment System (MIPS)

Final score

81.79 of 100Reported as group

Quality

71.65

Improvement activities

40

Cost

57.96

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• County of San Joaquin

  dba San Joaquin General Hospital

  • General Acute Care Hospital
  • French Camp, CA
  • NPI 1801830583
  Medicare reassignment Care Compare group
• San Joaquin Faculty Medical Group

  • Internal Medicine Physician
  • French Camp, CA
  • NPI 1225063761
  Medicare reassignment Care Compare group
• Delta Sierra Medical Group, Inc

  • Cardiovascular Disease Physician
  • French Camp, CA
  • NPI 1578598595
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• County of San Joaquin

  dba San Joaquin General Hospital

  • General Acute Care Hospital
  • French Camp, CA
  • NPI 1992870430
  Care Compare affiliation
• Port City Operating Company, LLC

  dba St. Joseph's Medical Center of Stockton

  • General Acute Care Hospital
  • Stockton, CA
  • NPI 1528190931
  Care Compare affiliation

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209513600000",
    "number": "1497965677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4864 JACKSON ST",
            "address_2": "DEPARTMENT OF FAMILY MEDICINE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712026400",
            "telephone_number": "318-330-7661",
            "fax_number": "318-330-7648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4864 JACKSON ST",
            "address_2": "DEPARTMENT OF FAMILY MEDICINE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712026400",
            "telephone_number": "318-330-7626",
            "fax_number": "318-330-7648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUNNAVA",
        "first_name": "BHANU",
        "middle_name": "P",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2008-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "201695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devanae Samone Wright
• Howard Wright, M.D.
• Joanna Wright, D.C.
• Timeka She'Ree Wright, M.S, LPC, NCC
• Stormy Lynn Wroten, CIT
• Chelsea Je'Nae Wyatt
• Earnest Christopher Wyatt Jr.
• Emily Bass Wyatt, ST
• Tiffany Wyatt
• Lane Wyble

• Family Medicine Physician in Monroe, LA
• Providers in Monroe, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.