NPIMap

Individual provider Active NPI

Victor G. Carabello, M.D.

  • Nephrology Physician
  • Los Angeles, CA
National Provider Identifier
1649293705
Registry record updated Sep 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
G74827 Issued in CA
Practice address
1701 E Cesar E Chavez Ave
Suite #100
Los Angeles, CA 90033-2464
Phone
(323) 987-1362
Fax
(323) 987-1365
NPI assigned
Jul 26, 2006
Last updated
Sep 15, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X G74827 CA Primary

Addresses

Primary practice location

1701 E Cesar E Chavez Ave
Suite #100
Los Angeles, CA 90033-2464

Mailing address

1700 E Cesar E Chavez Ave
Ste L-200
Los Angeles, CA 90033-2424
Phone (323) 526-2880

Other identifiers 1

IdentifierTypeStateIssuer
00G748270MedicaidCA

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
I20110225000443 CA Practitioner - Internal MedicinePractitioner - Nephrology 3072507854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
University of California, Irvine, California College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

605 N Mednik Ave
Los Angeles, CA 90022-1326
Phone (323) 526-2880

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
G74827CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Past Accepting new patients
Dignity Community Care Past Accepting new patients
Alta Los Angeles Hospital, Inc Past Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients
White Memorial Medical Center Past Accepting new patients
Eladh, LP Past Accepting new patients
Carabello Dialysis Center Inc PastSince Nov 14, 2007 Accepting new patients
Ahmc Monterey Park Hospital LP Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 10

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 9

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410739200000",
    "number": "1649293705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 E CESAR E CHAVEZ AVE",
            "address_2": "STE L-200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332424",
            "telephone_number": "323-526-2880",
            "fax_number": "323-526-2885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E CESAR E CHAVEZ AVE",
            "address_2": "SUITE #100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332464",
            "telephone_number": "323-987-1362",
            "fax_number": "323-987-1365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARABELLO",
        "first_name": "VICTOR",
        "middle_name": "G.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2014-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "G74827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G748270",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.