NPIMap

Individual provider Active NPI

Thavinsakdi Viravathana, M.D.

  • Therapeutic Radiology Physician
  • Hemet, CA
National Provider Identifier
1720022965
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Therapeutic Radiology PhysicianTaxonomy code 2085R0203X
License
A34942 Issued in CA
Practice address
890 W Stetson Ave Ste B
Apex Radiology Medical Group, Inc.
Hemet, CA 92543-7311
Phone
(951) 537-6002
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Therapeutic Radiology Physician 2085R0203X A34942 CA Primary

Addresses

Primary practice location

890 W Stetson Ave Ste B
Apex Radiology Medical Group, Inc.
Hemet, CA 92543-7311

Mailing address

890 W Stetson Ave Ste B
Hemet, CA 92543-7311
Phone (951) 537-6002

Other identifiers 4

IdentifierTypeStateIssuer
00A349420MedicaidCA
00A349421OtherMEDICARE PTAN
300127206OtherCARAILROAD
00A349422OtherMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A34924CAMDFamily Medicine Physician
A34942CAMDTherapeutic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hemet Valley Medical Center Past Accepting new patients
Menifee Valley Medical Center Past Accepting new patients
Hemet Radiology Medical Group, Inc. Past Accepting new patients
Renaissance Radiology Medical Group, Inc. Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362009600000",
    "number": "1720022965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 W STETSON AVE STE B",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925437311",
            "telephone_number": "951-537-6002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 W STETSON AVE STE B",
            "address_2": "APEX RADIOLOGY MEDICAL GROUP, INC.",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925437311",
            "telephone_number": "951-537-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIRAVATHANA",
        "first_name": "THAVINSAKDI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2013-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "CA",
            "license": "A34942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A349420",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "00A349421",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "300127206",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "00A349422",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hemet, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.