Individual provider Active NPI

Praful Sarode, M.D.

  • Pediatrics Physician
  • Santa Ana, CA
National Provider Identifier
1669560231
Registry record updated Jan 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A43383 Issued in CA
Practice address
999 N Tustin Ave
Suite # 124
Santa Ana, CA 92705-3528
Phone
(714) 547-5444
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2008

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

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A43383 CA
Family Medicine Physician 207Q00000X 31704 AZ
Pediatrics Physician 208000000X A43383 CA Primary
Pediatrics Physician 208000000X 31704 AZ
Neonatal-Perinatal Medicine Physician 2080N0001X A43383 CA
Neonatal-Perinatal Medicine Physician 2080N0001X 31704 AZ
Pediatric Critical Care Medicine Physician 2080P0203X A43383 CA
Pediatric Critical Care Medicine Physician 2080P0203X 31704 AZ
Pediatric Pulmonology Physician 2080P0214X A43383 CA
Pediatric Pulmonology Physician 2080P0214X 31704 AZ
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X A43383 CA
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X 31704 AZ
Hospitalist Physician 208M00000X A43383 CA
Hospitalist Physician 208M00000X 31704 AZ

Addresses

Primary practice location

999 N Tustin Ave
Suite # 124
Santa Ana, CA 92705-3528

Mailing address

999 N Tustin Ave
Suite # 124
Santa Ana, CA 92705-3528
Phone (714) 547-5444

Other identifiers 1

IdentifierTypeStateIssuer
00A433834MedicaidCA

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
I20040317000801 CA Practitioner - Pediatric MedicinePractitioner - General PracticePractitioner - Critical Care (Intensivists)Practitioner - Undersea and Hyperbaric Medicine 8729978465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Critical Care (Intensivists), General Practice, Undersea and Hyperbaric Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

999 N Tustin Ave
Suite 124
Santa Ana, CA 92705-6505
Phone (714) 547-5444

Hospital & facility affiliations

  • Uci Health-Orange Hospital, Orange, CA, CCN 050348

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31704AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Praful Sarode MD Inc Family Medicine CurrentSince May 30, 2013 Accepting new patients
Providence Medical Foundation Family Medicine PastSince May 30, 2013 Accepting new patients

Locations

17456 Beach Blvd
Ste 101
Huntington Beach, CA 92647
Phone (714) 847-8551

17456 Beach Blvd
#101
Huntington Beach, CA 92647
Phone (714) 847-8551

999 N Tustin Ave
Ste 124
Santa Ana, CA 92705
Phone (714) 547-5444

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: psarodemd17708@direct.memorialcare.org

Organizations & group practices 2

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 2

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200182400000",
    "number": "1669560231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 N TUSTIN AVE",
            "address_2": "SUITE # 124",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053528",
            "telephone_number": "714-547-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 N TUSTIN AVE",
            "address_2": "SUITE # 124",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053528",
            "telephone_number": "714-547-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARODE",
        "first_name": "PRAFUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2008-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A43383",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "31704",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A43383",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "31704",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CA",
            "license": "A43383",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "AZ",
            "license": "31704",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CA",
            "license": "A43383",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "AZ",
            "license": "31704",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "CA",
            "license": "A43383",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "AZ",
            "license": "31704",
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "CA",
            "license": "A43383",
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "AZ",
            "license": "31704",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A43383",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AZ",
            "license": "31704",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A433834",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.