NPIMap

Individual provider Active NPI

Lakshman D Makandura, M.D

  • Internal Medicine Physician
  • West Covina, CA
National Provider Identifier
1578614657
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A049715 Issued in CA
Practice address
910 S Sunset Ave
Suite # 8
West Covina, CA 91790-3409
Phone
(626) 338-8407
Fax
(626) 338-3937
NPI assigned
Jan 15, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 A049715 CA Primary

Addresses

Primary practice location

910 S Sunset Ave
Suite # 8
West Covina, CA 91790-3409

Mailing address

910 S Sunset Ave
Suite # 8
West Covina, CA 91790-3409
Phone (626) 338-8407

Other identifiers 1

IdentifierTypeStateIssuer
00A497153OtherCAMEDI CAL

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
I20100215000240 CA Practitioner - Internal Medicine 7214010255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

910 S Sunset Ave
Suite 8
West Covina, CA 91790-3409
Phone (626) 338-8407

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49715CAMDPharmacist
A049715CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakshman D Makandura MD Inc Internal Medicine CurrentSince Jun 25, 2012 Accepting new patients
Greater Valley Physicians Medical Group Inc Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
San Dimas Community Hospital, Inc. Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Medwin Hospitalist and Healthcare Network PastSince Jan 11, 2010 Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Emanate Health Foothill Presbyterian Hospital Past Accepting new patients

Locations

2225 N Perris Blvd
Perris, CA 92571
Phone (951) 657-2135

910 S Sunset Ave
Ste 8
West Covina, CA 91790
Phone (626) 338-8407

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
N/aLos Angeles, CA, CCN 050763 Hospital Contracted Managing Employee Jan 1, 2023
Long Beach Care CenterLong Beach, CA, CCN 056188 Skilled nursing facility Corporate Director Jan 1, 2015

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578614657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 S SUNSET AVE",
            "address_2": "SUITE # 8",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903409",
            "telephone_number": "626-338-8407",
            "fax_number": "626-338-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 S SUNSET AVE",
            "address_2": "SUITE # 8",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903409",
            "telephone_number": "626-338-8407",
            "fax_number": "626-338-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKANDURA",
        "first_name": "LAKSHMAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A049715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI CAL",
            "identifier": "00A497153",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.