NPIMap

Individual provider Active NPI

Charles Louis Pankratz, M.D.

  • Internal Medicine Physician
  • Ventura, CA
National Provider Identifier
1689610511
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A064556 Issued in CA
Practice address
2705 Loma Vista Rd Ste 202
Ventura, CA 93003-1580
Phone
(805) 667-2273
Fax
(805) 652-6379
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X A64556 CA
Internal Medicine Physician 207R00000X A064556 CA Primary

Addresses

Primary practice location

2705 Loma Vista Rd Ste 202
Ventura, CA 93003-1580

Mailing address

5855 Olivas Park Dr
Suite 203
Ventura, CA 93003-7672
Phone (805) 667-2801

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
I20060717000099 CA Practitioner - Internal MedicinePractitioner - Other (Physician) 8820001845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of California, Davis School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Memorial Health SystemGroup PAC ID 9537155676, 187 clinicians

Practice addresses (Care Compare)

147 N Brent St
Ventura, CA 93003-2809
Phone (805) 652-5011

Hospital & facility affiliations

  • Mission Hospice of Ventura, LLC Hospice, Oxnard, CA, CCN 551754
  • Mission Hospice Services of Los Angeles LLC Hospice, Westlake Village, CA, CCN 051786
  • Mission Hospice Services of San Diego LLC Hospice, San Diego, CA, CCN 551652
  • Community Memorial Hospital - Ventura Hospital, Ventura, CA, CCN 050394

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A064556CAMDInternal Medicine Physician
A64556CAMDHospice and Palliative Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Memorial Health System CurrentSince Dec 1, 2010 Accepting new patients
Community Memorial Health System Hospice and Palliative Medicine Current Accepting new patients
Community Memorial Health System CurrentSince Dec 1, 2010 Accepting new patients

Locations

422 Arneill Rd
Ste B
Camarillo, CA 93010
Phone (805) 383-4510

2921 Saviers Rd
Oxnard, CA 93033
Phone (805) 487-5588

2793 Loma Vista Rd
Ventura, CA 93003
Phone (805) 643-9292

147 N Brent St
Ventura, CA 93003
Phone (805) 652-5011

138 W Main St
Ste E
Ventura, CA 93001
Phone (805) 667-2850

5855 Olivas Park Dr
Ventura, CA 93003
Phone (805) 652-5469

5855 Olivas Park Dr
Ste 203
Ventura, CA 93003

Interoperability endpoints

  • Direct secure messaging: charlespankratz@vecp.allscriptsdirect.net

Ownership & related parties

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Mission Hospice of Ventura LLCOxnard, CA, CCN 551754 Hospice Contracted Managing Employee Jun 18, 2024
Mission Hospice Services of Los Angeles LLCWestlake Village, CA, CCN 051786 Hospice Contracted Managing Employee Jul 23, 2019

Owned or controlled facilities with NPI records 2

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

Organizations & group practices 3

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1689610511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 OLIVAS PARK DR",
            "address_2": "SUITE 203",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930037672",
            "telephone_number": "805-667-2801",
            "fax_number": "805-667-2865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 LOMA VISTA RD STE 202",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031580",
            "telephone_number": "805-667-2273",
            "fax_number": "805-652-6379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANKRATZ",
        "first_name": "CHARLES",
        "middle_name": "LOUIS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "CA",
            "license": "A64556",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A064556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.