NPIMap

Individual provider Active NPI

Prema Reddy Bezwada, M.D.

  • Cardiovascular Disease Physician
  • Carmichael, CA
National Provider Identifier
1609264704
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A167422 Issued in CA
Practice address
6555 Coyle Ave Ste 280
Carmichael, CA 95608-0302
Phone
(916) 536-3560
Fax
(916) 536-3567
NPI assigned
Dec 26, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A167422 CA Primary

Addresses

Primary practice location

6555 Coyle Ave Ste 280
Carmichael, CA 95608-0302

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956

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
I20200826002779 CA Practitioner - Cardiovascular Disease (Cardiology) 4789001405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

6555 Coyle Ave
Suite 280
Carmichael, CA 95608-0302
Phone (916) 536-3560

Hospital & facility affiliations

  • Mercy San Juan Medical Center Hospital, Carmichael, CA, CCN 050516
  • Mercy Hospital of Folsom Hospital, Folsom, CA, CCN 050414
  • Mercy General Hospital Hospital, Sacramento, CA, CCN 050017
  • St Joseph'S Medical Center of Stockton Hospital, Stockton, CA, CCN 050084
  • Sierra Nevada Memorial Hospital Hospital, Grass Valley, CA, CCN 050150

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A167422CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation Current Accepting new patients
Dignity Health Medical Foundation CurrentSince Sep 6, 2022 Accepting new patients
Dignity Health Medical Foundation CurrentSince Sep 6, 2022 Accepting new patients
Dignity Health Past Accepting new patients
Dignity Health Medical Foundation Past Accepting new patients
Dignity Community Care Past Accepting new patients
Dignity Health Past Accepting new patients
Sierra Nevada Memorial-Miners Hospital Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

6555 Coyle Ave
Ste 280
Carmichael, CA 95608
Phone (916) 536-3540

9394 Big Horn Blvd
Elk Grove, CA 95758
Phone (916) 351-4800

1561 Creekside Dr
Ste 150
Folsom, CA 95630
Phone (916) 983-2193

150 Catherine Ln
Ste Df
Grass Valley, CA 95945

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

3000 Q St
Sacramento, CA 95816
Phone (916) 733-5701

Interoperability endpoints

  • Direct secure messaging: pbezwada8406@prd.direct.tbh.org

Organizations & group practices 9

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.

Hospital & facility affiliations 5

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": "1419552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1609264704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6555 COYLE AVE STE 280",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956080302",
            "telephone_number": "916-536-3560",
            "fax_number": "916-536-3567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEZWADA",
        "first_name": "PREMA",
        "middle_name": "REDDY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-26",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A167422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmichael, CA

Sources for this page

Verify at the official NPI Registry.