NPIMap

Individual provider Active NPI

Kishor Avasarala, M.D.

  • Pediatric Cardiology Physician
  • Oakland, CA
National Provider Identifier
1508853011
Registry record updated Jun 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
A63007 Issued in CA
Practice address
747 52ND St
Cardiology
Oakland, CA 94609-1809
Phone
(510) 428-3294
Fax
(510) 428-3381
NPI assigned
Sep 29, 2005
Last updated
Jun 19, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X A63007 CA Primary

Addresses

Primary practice location

747 52ND St
Cardiology
Oakland, CA 94609-1809

Mailing address

747 52ND St
Cardiology
Oakland, CA 94609-1809
Phone (510) 428-3294

Other identifiers 1

IdentifierTypeStateIssuer
00A630070MedicaidCA

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
I20110602000638 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 3173503935 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Pediatric Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
UCSF Pediatrics AssociatesGroup PAC ID 6204749112, 102 clinicians

Practice addresses (Care Compare)

505 Parnassus Ave
San Francisco, CA 94143-2204
Phone (415) 476-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63007CAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco CurrentSince Mar 15, 2016 Accepting new patients
UCSF Medical Group Business Services CurrentSince Mar 15, 2016 Accepting new patients
UCSF Pediatrics Associates Pediatric Cardiology CurrentSince Mar 15, 2016 Accepting new patients
UCSF Medical Group Business Services CurrentSince Mar 15, 2016 Accepting new patients
University of California San Francisco CurrentSince Mar 15, 2016 Accepting new patients
University of California San Francisco Pediatric Cardiology Current Accepting new patients
Children's Hospital & Research Center at Oakland Past Accepting new patients
Alta Bates Summit Medical Center Past Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients
John Muir Health Past Accepting new patients
Lucile Salter Packard Children's Hospital at Stanford Past Accepting new patients
Eden Medical Center/San Leandro Hospital Campus Past Accepting new patients
San Ramon Regional Medical Center, LLC Past Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

400 Parnassus Ave
San Francisco, CA 94143
Phone (415) 353-2000

400 Parnassus Ave
#300
San Francisco, CA 94143
Phone (415) 476-3131

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

Interoperability endpoints

  • Direct secure messaging: kavasarala78454@direct-ucsfmedicalcenter.org

Organizations & group practices 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1508853011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 52ND ST",
            "address_2": "CARDIOLOGY",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "510-428-3294",
            "fax_number": "510-428-3381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 52ND ST",
            "address_2": "CARDIOLOGY",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "510-428-3294",
            "fax_number": "510-428-3381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVASARALA",
        "first_name": "KISHOR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "A63007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A630070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.