Individual provider Active NPI

Dinesh Vyas, MD

  • Surgery Physician
  • Stockton, CA
National Provider Identifier
1528274503
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4301099055 Issued in MI
Practice address
3133 W March LN Ste 1040B
Stockton, CA 95219-2360
Phone
(314) 260-7609
Fax
(517) 267-2462
NPI assigned
May 15, 2007
Last updated
Jan 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 57.011768 OH
Surgery Physician 208600000X 2009006855 MO
Surgery Physician 208600000X 4301099055 MI Primary

Addresses

Primary practice location

3133 W March LN Ste 1040B
Stockton, CA 95219-2360

Mailing address

9717 Ruddy Duck Way
Elk Grove, CA 95757-8155
Phone (314) 260-7609

Other identifiers 2

IdentifierTypeStateIssuer
1528274503MedicaidMI
9810335OtherMOAETNA

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
I20171122002223 CA Practitioner - General Surgery 9931252731 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3133 W March LN
Suite 1040B
Stockton, CA 95219-2360
Phone (314) 260-7609

9717 Ruddy Duck Way
Elk Grove, CA 95757-8155

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy24
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57.011768OHMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Joaquin Faculty Medical Group CurrentSince Sep 2, 2017 Accepting new patients
County of San Joaquin CurrentSince Sep 2, 2017 Accepting new patients
County of San Joaquin CurrentSince Sep 2, 2017 Accepting new patients
MV Surgical Associates LLC Surgery CurrentSince Nov 15, 2010 Accepting new patients
Vyas Medical Corp Surgery CurrentSince Jul 31, 2023 Accepting new patients
County of San Joaquin Past Accepting new patients
Dameron Hospital Association Past Accepting new patients

Locations

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

8715 Center Pkwy
Sacramento, CA 95823
Phone (209) 565-1691

3133 W March Ln
Ste 1040B
Stockton, CA 95219
Phone (314) 260-7609

3535 S Jefferson Ave
Ste 2
Saint Louis, MO 63118
Phone (314) 577-5778

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: dinesh.vyas.2@8236.direct.athenahealth.com

Organizations & group practices 7

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 1

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1528274503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9717 RUDDY DUCK WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957578155",
            "telephone_number": "314-260-7609",
            "fax_number": "314-260-7609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3133 W MARCH LN STE 1040B",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952192360",
            "telephone_number": "314-260-7609",
            "fax_number": "517-267-2462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VYAS",
        "first_name": "DINESH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "57.011768",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2009006855",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301099055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528274503",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9810335",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.