Venkat Devineni, MD, Inc

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

A54340 Issued in CA

Legal business name

VENKAT DEVINENI, MD, INC

Doing business as

Radiant Heart Institute

Practice address

17259 Jasmine St
Suite B
Victorville, CA 92395-7787

Phone

(760) 951-7778

Fax

(760) 951-7760

NPI assigned

Jul 31, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Venkat Devineni, M.D.NPI 1588650675

Title

Owner

Phone

(760) 951-7778

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• RADIANT HEART INSTITUTE Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Venkat Devineni, MD

  • Cardiovascular Disease Physician
  • Victorville, CA
  • NPI 1588650675
  Medicare reassignment NPD Authorized official
• Kristen Moore, PT, DPT

  • Orthopedic Physical Therapist
  • Santa Ana, CA
  • NPI 1942811062
  NPD (past)

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

{
    "created_epoch": "1248998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248998400000",
    "number": "1619108164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1537",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923931537",
            "telephone_number": "760-951-7778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17259 JASMINE ST",
            "address_2": "SUITE B",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957787",
            "telephone_number": "760-951-7778",
            "fax_number": "760-951-7760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VENKAT DEVINENI, MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-31",
        "last_updated": "2009-07-31",
        "status": "A",
        "authorized_official_last_name": "DEVINENI",
        "authorized_official_first_name": "VENKAT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-951-7778",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "A54340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A543400",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RADIANT HEART INSTITUTE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Linda Velasquez
• Lydia Deanne Velasquez, CADC I
• Rosalinda Velazquez-Roman
• Leslie Rochelle Velehradsky, RADTI
• Michael Venegas
• Edgard Mario Vera Tapia, MD
• Pedro Vera
• Rico Vestil, PTA
• Cassandra Marie Vetter, M.S
• Via Nova Stabilization & Reentry Network LLC

• Medical Specialty Clinic/Center in Victorville, CA
• Providers in Victorville, CA by specialty
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.