Individual provider Active NPI

Vidyadhar V Upasani, M.D.

  • Orthopaedic Surgery Physician
  • San Diego, CA
National Provider Identifier
1548417652
Registry record updated Nov 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
A97603 Issued in CA
Practice address
3030 Children'S Way
San Diego, CA 92123-4223
Phone
(858) 966-6789
Fax
(858) 966-8519
NPI assigned
Aug 20, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X A97603 CA Primary

Addresses

Primary practice location

3030 Children'S Way
San Diego, CA 92123-4223

Mailing address

3020 Childrens Way
MC 5003
San Diego, CA 92123-4223
Phone (858) 309-6300

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
I20131231000854 CA Practitioner - Orthopedic Surgery 7113155805 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A97603CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rady Children'S Hospital San Diego CurrentSince Oct 20, 2013 Accepting new patients
Rady Children'S Hospital San Diego CurrentSince Oct 20, 2013 Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation Past Accepting new patients

Locations

2125 Citracado Pkwy
Ste 100
Escondido, CA 92029
Phone (760) 739-1543

25170 Hancock Ave
Fl 1
Murrieta, CA 92562

25170 Hancock Ave
Murrieta, CA 92562
Phone (858) 757-3277

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841

3020 Childrens Way
#5062
San Diego, CA 92123

3030 Childrens Way
Fl 3
San Diego, CA 92123
Phone (858) 966-6789

3020 Childrens Way
#5003
San Diego, CA 92123
Phone (858) 309-6300

3030 Childrens Way
San Diego, CA 92123
Phone (858) 966-4003

Interoperability endpoints

  • Direct secure messaging: vupasani13139@radychildrens.direct-ci.com

Organizations & group practices 3

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": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415318400000",
    "number": "1548417652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY",
            "address_2": "MC 5003",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-309-6300",
            "fax_number": "858-309-6301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 CHILDREN'S WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-966-6789",
            "fax_number": "858-966-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPASANI",
        "first_name": "VIDYADHAR",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-20",
        "last_updated": "2014-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A97603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.