Active NPI
Bruce Edwin Vannatta, MD
- Interventional Cardiology Physician
- Los Alamitos, CA
National Provider Identifier
1629074877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Cardiology Physician
- License
- C39931
- Practice address
- 3801 Katella Ave
Suite 401
Los Alamitos, CA 90720-3338 - Phone
- (562) 598-3200
- Fax
- (562) 799-3646
- NPI assigned
- Jun 22, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Interventional Cardiology Physician | 207RI0011X | C39931 | CA | Primary |
| Cardiovascular Disease Physician | 207RC0000X | C39931 | CA |
Addresses
Primary practice location
3801 Katella Ave
Suite 401
Los Alamitos, CA 90720-3338
Mailing address
3801 Katella Ave
Suite 401
Los Alamitos, CA 90720-3338
Phone (562) 598-3200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00C399310 | Medicaid | CA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Indiana University School of Medicine, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3801 Katella Ave
Suite 401
Los Alamitos, CA 90720-3375
Phone (562) 594-1772
Hospital & facility affiliations
- Hollywood Home Health Services
- Uci Health-Orange
- St Mary Medical Center
- Memorialcare Long Beach Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.69 of 100
- Quality
- 80.77
- Promoting interoperability
- 88
- Improvement activities
- 40
- Cost
- 68.21
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 32 |
| Pacemaker insertion or repair | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C39931 | CA | MD | Interventional Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cardiovascular Care Inc | Cardiovascular Disease | Current | Accepting new patients |
| Los Alamitos Medical Center, Inc. | Past | Accepting new patients | |
| Long Beach Memorial Medical | Past | Accepting new patients |
Locations
1050 Linden Ave
Long Beach, CA 90813
Phone (562) 491-9000
2530 Atlantic Ave
Ste D
Long Beach, CA 90806
Phone (562) 426-0401
3801 Katella Ave
Ste 401
Los Alamitos, CA 90720
Phone (562) 594-1772
Interoperability endpoints
- brucevannatta@cc.allscriptsdirect.net
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.
-
- Cardiovascular Disease Physician
- Los Alamitos, CA
- NPI 1295877546
-
- Rehabilitation Hospital Unit
- Long Beach, CA
- NPI 1396791414
-
- Psychiatric Hospital Unit
- Los Alamitos, CA
- NPI 1497780084
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Long Beach, CA
- NPI 1194840421
-
- Home Health Agency
- North Hollywood, CA
- NPI 1114996154
-
- General Acute Care Hospital
- Long Beach, CA
- NPI 1962442012
-
- General Acute Care Hospital
- Orange, CA
- NPI 1689608150
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555977600000",
"number": "1629074877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3801 KATELLA AVE",
"address_2": "SUITE 401",
"city": "LOS ALAMITOS",
"state": "CA",
"postal_code": "907203338",
"telephone_number": "562-598-3200",
"fax_number": "562-799-3646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3801 KATELLA AVE",
"address_2": "SUITE 401",
"city": "LOS ALAMITOS",
"state": "CA",
"postal_code": "907203338",
"telephone_number": "562-598-3200",
"fax_number": "562-799-3646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANNATTA",
"first_name": "BRUCE",
"middle_name": "EDWIN",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-22",
"last_updated": "2019-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "CA",
"license": "C39931",
"primary": true
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "CA",
"license": "C39931",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00C399310",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Alamitos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.