Mysore R Nagaraja, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

A25685 Issued in CA

Practice address

811 E 11TH St Ste 208
Upland, CA 91786-4872

Phone

(909) 982-2279

Fax

(909) 946-3070

NPI assigned

Mar 16, 2006

Last updated

Sep 18, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Gastroenterology

Education

Other, 1970

Medicare assignment

May accept Medicare assignment

Group practices

Complete Care Community Health Center, IncGroup PAC ID 3779494190, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Holy Cross Medical Center Hospital, Mission Hills, CA, CCN 050278

Merit-based Incentive Payment System (MIPS)

Final score

78.08 of 100Reported as group

Quality

40.87

Promoting interoperability

75

Improvement activities

40

Cost

74.84

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: mysore.nagaraja.p1@direct.ccchcenter.nextgenshare.com
• Direct secure messaging: mysore.nagaraja@mnrinc.direct-geniusdoc.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Complete Care Community Health Center, Inc

  • PACE Provider Organization
  • Los Angeles, CA
  • NPI 1215113964
  Medicare reassignment Care Compare group NPD
• Mysore R Nagaraja,M.D.,Inc

  • Gastroenterology Physician
  • Northridge, CA
  • NPI 1851436687
  Medicare reassignment NPD Authorized official
• Chaparral Medical Group, Inc.

  • Dermatology Physician
  • Rancho Cucamonga, CA
  • NPI 1093777666

  Internal Medicine

  Medicare reassignment NPD
• Chaparral Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • Pomona, CA
  • NPI 1477733624
  Medicare reassignment NPD
• Chaparral Medical Group Inc

  • Neurological Surgery Physician
  • Pomona, CA
  • NPI 1386606259
  NPD
• Chaparral Medical Group Inc.

  • Cardiovascular Disease Physician
  • Upland, CA
  • NPI 1639869605
  NPD
• Chaparral Medical Group, Inc.

  • Cardiovascular Disease Physician
  • Chino, CA
  • NPI 1821554866

  Internal Medicine

  NPD
• Complete Care Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Visalia, CA
  • NPI 1316729403
  NPD

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

• Providence Health System - Southern California

  dba Providence Holy Cross Medical Center

  • General Acute Care Hospital
  • Mission Hills, CA
  • NPI 1477587632
  Care Compare affiliation

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1760451298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST STE 200",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913255407",
            "telephone_number": "818-363-3105",
            "fax_number": "818-363-6178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 E 11TH ST STE 208",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864872",
            "telephone_number": "909-982-2279",
            "fax_number": "909-946-3070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "790 E Bonita Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "CA",
            "postal_code": "917671906",
            "country_code": "US",
            "telephone_number": "909-469-0033",
            "fax_number": "909-620-9146",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17075 Devonshire St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Northridge",
            "state": "CA",
            "postal_code": "913255407",
            "country_code": "US",
            "telephone_number": "818-363-3105",
            "fax_number": "818-363-6178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAGARAJA",
        "first_name": "MYSORE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A25685",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A25685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A256850",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "W5281",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Upland, CA
• Providers in Upland, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.