NPIMap

Individual provider Active NPI

Ravikiran Vegasana, M.D.

  • Nephrology Physician
  • Modesto, CA
National Provider Identifier
1770738825
Registry record updated Apr 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A129459 Issued in CA
Practice address
608 E Orangeburg Ave
Modesto, CA 95350-5513
Phone
(209) 529-2645
Fax
(209) 529-3024
NPI assigned
Nov 17, 2008
Last updated
Apr 25, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 35122842 OH
Nephrology Physician 207RN0300X A129459 CA Primary

Addresses

Primary practice location

608 E Orangeburg Ave
Modesto, CA 95350-5513

Mailing address

608 E Orangeburg Ave
Modesto, CA 95350-5513
Phone (209) 529-2645

Other practice location 1

421 Portage Trl
Cuyahoga Falls, OH 44221-3227
Phone (330) 331-4466

Other identifiers 2

IdentifierTypeStateIssuer
0103941MedicaidOH
CA272453OtherCAMEDICARE

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
I20171106001508 CA Practitioner - Nephrology 6305060153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Nephrology AssociatesGroup PAC ID 6709870330, 3 clinicians

Practice addresses (Care Compare)

608 E Orangeburg Ave
Modesto, CA 95350-5513
Phone (209) 529-2645

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35122842OHMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Nephrology Associates CurrentSince Oct 31, 2017 Accepting new patients
Pinnacle Sjir Current Accepting new patients
Robinson Memorial Portage County Hospital Past Accepting new patients
Emanuel Medical Center, Inc. Past Accepting new patients
Doctors Medical Center of Modesto, Inc. Past Accepting new patients
Emanuel County Hospital Authority Past Accepting new patients
Cuyahoga Falls General Hospital Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Akron General Medical Center Past Accepting new patients

Locations

1140 Norman Dr
Ste 4
Manteca, CA 95336
Phone (209) 823-3158

1144 Norman Dr
Ste 203
Manteca, CA 95336
Phone (209) 405-2406

608 E Orangeburg Ave
Modesto, CA 95350
Phone (209) 529-2645

1729 N Olive Ave
Ste 11
Turlock, CA 95382
Phone (209) 664-0410

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/73255
  • Direct secure messaging: ravikiranvegasana@vna.allscriptsdirect.net
  • Direct secure messaging: rvegasana391020@hisp.ehr.sutterhealth.org

Organizations & group practices 9

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.

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1226880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524614400000",
    "number": "1770738825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 E ORANGEBURG AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505513",
            "telephone_number": "209-529-2645",
            "fax_number": "209-529-3024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 E ORANGEBURG AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505513",
            "telephone_number": "209-529-2645",
            "fax_number": "209-529-3024"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "421 Portage Trl",
            "address_purpose": "LOCATION",
            "city": "Cuyahoga Falls",
            "state": "OH",
            "postal_code": "442213227",
            "country_code": "US",
            "telephone_number": "330-331-4466",
            "fax_number": "330-331-7478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VEGASANA",
        "first_name": "RAVIKIRAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-17",
        "last_updated": "2018-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OH",
            "license": "35122842",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A129459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0103941",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "CA272453",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.