Individual provider Active NPI

Ravi Mandapati, M.D.

  • Pediatrics Physician
  • Loma Linda, CA
National Provider Identifier
1639199565
Registry record updated Feb 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A77168 Issued in CA
Practice address
11370 Anderson St
Ste B-100
Loma Linda, CA 92354-3450
Phone
(909) 558-2848
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A77168 CA Primary
Cardiovascular Disease Physician 207RC0000X A77168 CA
Clinical Cardiac Electrophysiology Physician 207RC0001X A77169 CA

Addresses

Primary practice location

11370 Anderson St
Ste B-100
Loma Linda, CA 92354-3450

Mailing address

54701 File Number
Los Angeles, CA 90074-4701
Phone (909) 558-3111

Other identifiers 1

IdentifierTypeStateIssuer
00A771680MedicaidCA

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
I20090211000681 CA Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 8426113275 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Pediatric Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Faculty Physicians and Surgeons of LlusmGroup PAC ID 1153227814, 1,313 clinicians

Practice addresses (Care Compare)

11234 Anderson St
Loma Linda, CA 92354-2804

11370 Anderson St
Loma Linda, CA 92354-3450

12021 Jacaranda Ave
Hesperia, CA 92345-4978
Phone (909) 558-4207

8599 Haven Ave
Suite 102And210
Rancho Cucamonga, CA 91730-4849
Phone (909) 558-2806

901 San Bernardino Rd
Suite 104And302
Upland, CA 91786-4912
Phone (909) 558-4000

File Number
Suite 54701
Los Angeles, CA 90074-4701

Hospital & facility affiliations

  • Loma Linda University Medical Center Hospital, Loma Linda, CA, CCN 050327
  • Providence St Mary Medical Center Hospital, Apple Valley, CA, CCN 050300

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A77169CAMDClinical Cardiac Electrophysiology Physician
A77168CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Cardiovascular Disease Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Pediatrics Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jan 1, 2009 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Pediatrics Current Accepting new patients
Loma Linda University Children'S Hospital Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients

Locations

18182 Outer Highway 18
Ste 104
Apple Valley, CA 92307
Phone (760) 475-6965

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

11370 Anderson St
Ste B100
Loma Linda, CA 92354
Phone (909) 558-2848

11234 Anderson St
Fl 6
Loma Linda, CA 92350

11370 Anderson St
Ste 1800
Loma Linda, CA 92354
Phone (909) 558-2154

11234 Anderson St
#A600
Loma Linda, CA 92350
Phone (909) 558-2824

11234 Anderson St
Ste 1617
Loma Linda, CA 92350
Phone (909) 558-2848

11370 Anderson St
Ste 2600
Loma Linda, CA 92354
Phone (909) 558-2890

11234 Anderson St
Fl 7
Loma Linda, CA 92350

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

54701 File Number
Los Angeles, CA 90074

28078 Baxter Rd
Murrieta, CA 92563
Phone (951) 290-4000

Interoperability endpoints

  • Direct secure messaging: rmandapati9006@direct.llu.edu

Organizations & group practices 11

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 4

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265673600000",
    "number": "1639199565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54701 FILE NUMBER",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900744701",
            "telephone_number": "909-558-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11370 ANDERSON ST",
            "address_2": "STE B-100",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543450",
            "telephone_number": "909-558-2848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDAPATI",
        "first_name": "RAVI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2010-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A77168",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A77168",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "CA",
            "license": "A77169",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A771680",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.