Providence Ambulatory Services Inc

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

Legal business name

PROVIDENCE AMBULATORY SERVICES INC

Practice address

3975 Jackson St Ste 105
Riverside, CA 92503-3945

Phone

(951) 775-2407

NPI assigned

Nov 3, 2022

Last updated

Nov 3, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nawal Badran, MD

Title

President

Phone

(951) 775-2407

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Calvin Purushottam Patel, MD

  • Family Medicine Physician
  • Riverside, CA
  • NPI 1518369289

  Hospitalist

  Medicare reassignment Care Compare group NPD
• Garvin Sidharaj Patel, M.D.

  • Internal Medicine Physician
  • Corona, CA
  • NPI 1992932800

  Hospitalist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1667433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667433600000",
    "number": "1710694161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3975 JACKSON ST STE 105",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033945",
            "telephone_number": "951-775-2407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 JACKSON ST STE 105",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033945",
            "telephone_number": "951-775-2407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE AMBULATORY SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-03",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A",
        "authorized_official_last_name": "BADRAN",
        "authorized_official_first_name": "NAWAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-775-2407",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prompt Laboratories Inc
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• Robert Jon Propst, DO
• Prosum DME LLC (ProSUM Health)
• Providence Community Services
• Providence Healthcare Partners,, Inc
• Stephen G. Provonsha, MD
• Proxcell Inc.
• Matthew James Pryor, MD

• Hospitalist Physician in Riverside, CA
• Providers in Riverside, CA by specialty
• Hospitalist Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.