Individual provider Active NPI

Manita Choudhary, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Eastvale, CA
National Provider Identifier
1730543752
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
A158357 Issued in CA
Practice address
12742 Limonite Ave
Eastvale, CA 92880-9630
Phone
(951) 739-2717
Fax
(951) 371-6586
NPI assigned
Apr 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X A158357 CA Primary

Addresses

Primary practice location

12742 Limonite Ave
Eastvale, CA 92880-9630

Mailing address

12742 Limonite Ave
Eastvale, CA 92880-9630

Other practice location 1

21634 Retreat Pkwy
Corona, CA 92883-6100
Phone (951) 739-2717

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
I20210813000773 CA Practitioner - Endocrinology 5890034854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Riverside Medical Clinic IncGroup PAC ID 2961492327, 173 clinicians

Practice addresses (Care Compare)

6405 Day St
Riverside, CA 92507-0901
Phone (951) 697-5556

7117 Brockton Ave
Riverside, CA 92506-2658
Phone (951) 683-6370

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A158357CAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles (3 of 4)

OrganizationSpecialtyStatusNew patients
Riverside Medical Clinic, Inc CurrentSince Aug 1, 2021 Accepting new patients
Riverside Medical Clinic, Inc CurrentSince Aug 1, 2021 Accepting new patients
Riverside Medical Clinic, Inc Current Accepting new patients

Locations

12742 Limonite Ave
Eastvale, CA 92880
Phone (951) 739-2712

3660 Arlington Ave
Riverside, CA 92506
Phone (951) 782-3789

21634 Retreat Pkwy
Temescal Valley, CA 92883
Phone (951) 782-5157

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

NPI Registry JSON

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

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1730543752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12742 LIMONITE AVE",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928809630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12742 LIMONITE AVE",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928809630",
            "telephone_number": "951-739-2717",
            "fax_number": "951-371-6586"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21634 Retreat Pkwy",
            "address_purpose": "LOCATION",
            "city": "Corona",
            "state": "CA",
            "postal_code": "928836100",
            "country_code": "US",
            "telephone_number": "951-739-2717",
            "fax_number": "951-371-6586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHOUDHARY",
        "first_name": "MANITA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-06",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A158357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastvale, CA

Sources for this page

Verify at the official NPI Registry.