NPIMap

Individual provider Active NPI

Kishore Babu Narra, M.D.

  • Internal Medicine Physician
  • Fremont, CA
National Provider Identifier
1649371709
Registry record updated Jun 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A45586 Issued in CA
Practice address
716 Mowry Ave
Fremont, CA 94536-4115
Phone
(510) 792-1390
Fax
(510) 792-1662
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A45586 CA Primary
Physical Medicine & Rehabilitation Physician 208100000X A45586 CA

Addresses

Primary practice location

716 Mowry Ave
Fremont, CA 94536-4115

Mailing address

716 Mowry Ave
Fremont, CA 94536-4115
Phone (510) 792-1390

Other identifiers 1

IdentifierTypeStateIssuer
0387822MedicaidCA

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
I20100831000303 CA Practitioner - Internal MedicinePractitioner - Physical Medicine and Rehabilitation 9436280138 Practice locations: Fremont, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Physical Medicine and Rehabilitation
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

716 Mowry Ave
Fremont, CA 94536-4115
Phone (510) 792-1390

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A45586CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Port City Operating Company, LLC Past Accepting new patients
Upmc Washington Past Accepting new patients
Washington Township Hospital District Past Accepting new patients
Hill Physicians Medical Group - PPO Program Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BDBGBA/Endpoint/BDBGBA

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St. Joseph Home HealthMilpitas, CA, CCN 059009 Home health agency Contracted Managing Employee Dec 30, 2009

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276214400000",
    "number": "1649371709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 MOWRY AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945364115",
            "telephone_number": "510-792-1390",
            "fax_number": "510-792-1662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 MOWRY AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945364115",
            "telephone_number": "510-792-1390",
            "fax_number": "510-792-1662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NARRA",
        "first_name": "KISHORE",
        "middle_name": "BABU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2010-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A45586",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A45586",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0387822",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.