Individual provider Active NPI

Vivek Ramakrishnan, DO

  • Neurological Surgery Physician
  • Colton, CA
National Provider Identifier
1649505009
Registry record updated Oct 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
20A11668 Issued in CA
Practice address
400 N Pepper Ave
Dept. Neurosurgery Mod# 3
Colton, CA 92324-1801
Phone
(909) 580-3353
Fax
(909) 580-1363
NPI assigned
Oct 2, 2009
Last updated
Oct 4, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 20A11668 CA Primary

Addresses

Primary practice location

400 N Pepper Ave
Dept. Neurosurgery Mod# 3
Colton, CA 92324-1801

Mailing address

PO Box 232410
Dept. Neurosurgery Mod# 3
San Diego, CA 92193-2410
Phone (619) 543-6164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151130000568 CA Practitioner - Neurosurgery 6002116944 Reassigns benefits to 1 organization
I20170724002889 NJ Practitioner - Neurosurgery 6002116944 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A11668CAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Current Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California - Ucsd Medical Group Current Accepting new patients
Regents of the University of California Current Accepting new patients
Advanced Neurosurgery Associates PC Neurological Surgery CurrentSince Jun 16, 2017 Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California CurrentSince Sep 1, 2016 Accepting new patients
Regents of the University of California Family Medicine Current Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California Neurological Surgery CurrentSince Sep 1, 2016 Accepting new patients
Regents of the University of California Current Accepting new patients

Locations

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

201 State Rt 17
Ste 501
Rutherford, NJ 07070
Phone (201) 457-0044

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1254441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1649505009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "address_2": "DEPT. NEUROSURGERY MOD# 3",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410",
            "telephone_number": "619-543-6164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "address_2": "DEPT. NEUROSURGERY MOD# 3",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-3353",
            "fax_number": "909-580-1363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMAKRISHNAN",
        "first_name": "VIVEK",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-02",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "20A11668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.