Gautam Vangipuram, M.D

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

C173301 Issued in CA

Practice address

2619 E Colorado Blvd Ste 150
Pasadena, CA 91107-3747

Phone

(626) 793-4168

Fax

(626) 793-6256

NPI assigned

Sep 14, 2015

Last updated

Jan 10, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Ophthalmology

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aarchan Joshi, M.D. IncGroup PAC ID 1052350980, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: gautam.vangipuram.p1@direct.atlantiseyecare.nextgenshare.com
• Direct secure messaging: gvangipuram@bcr.intellechartdirect.net
• FHIR API: https://fhir-myrecord.cerner.com/r4/f62890b5-77ff-44bd-a981-0a0981047b35/
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Aarchan Joshi, M.D. Inc

  • Ophthalmology Physician
  • Redondo Beach, CA
  • NPI 1306924238
  Medicare reassignment Care Compare group NPD
• Gautam Vangipuram MD Inc

  dba Beach Cities Retina

  • Retina Specialist (Ophthalmology) Physician
  • Hermosa Beach, CA
  • NPI 1699474163
  Medicare reassignment NPD Authorized official
• Retina Consultants of Orange County, a Medical Corporation

  • Retina Specialist (Ophthalmology) Physician
  • Fullerton, CA
  • NPI 1770539702
  Medicare reassignment NPD
• Azul Vision Inc.

  dba Azul Vision

  • Ophthalmology Physician
  • Pasadena, CA
  • NPI 1285247528
  NPD (past)
• Hecht Eye Institute Inc

  dba Matthew L. Hecht M.D.

  • Ophthalmology Physician
  • Lawndale, CA
  • NPI 1205132370
  NPD (past)
• Riverside Eye Partners a Professional Medical Corporation

  • Medical Specialty Clinic/Center
  • Riverside, CA
  • NPI 1710460878
  NPD (past)
• Hermann Area Hospital District

  dba Hermann Area District Hospital

  • Family Medicine Physician
  • Hermann, MO
  • NPI 1083749188
  NPD (past)
• The Retina Institute LLC

  dba Barnes Retina Institute

  • Ophthalmology Physician
  • Saint Louis, MO
  • NPI 1407858673
  NPD (past)

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

• Torrance Memorial Medical Center

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1467459776
  Care Compare affiliation

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

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1780052233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 W GARVEY AVE S UNIT 335",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902656",
            "telephone_number": "626-305-9100",
            "fax_number": "626-305-9150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2619 E COLORADO BLVD STE 150",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073747",
            "telephone_number": "626-793-4168",
            "fax_number": "626-793-6256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANGIPURAM",
        "first_name": "GAUTAM",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-14",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "2019018140",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "MO",
            "license": "2019018140",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "CA",
            "license": "C173301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Joseph Vandyke, M.D.
• Heather Vanegas
• Vanessa a. Isiaka, M.D., Inc.
• Joshua Vang
• John S Vangerov, M.F.T
• Vanguard Surgical Associates
• Lauren Vanorsdale, AMFT, APCC
• Frederick Vaquer, M.D.
• Clara Vara Escamilla
• Gita Aanjalie Varaprasathan, M.D.

• Retina Specialist (Ophthalmology) Physician in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Retina Specialist (Ophthalmology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.