Individual provider Active NPI

Madhu R Agarwal, M.D.

  • Ophthalmology Physician
  • Redlands, CA
National Provider Identifier
1780609933
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A73978 Issued in CA
Practice address
1200 California St
Ste 140
Redlands, CA 92374-2945
Phone
(909) 792-6000
NPI assigned
Jul 12, 2006
Last updated
Dec 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A73978 CA Primary

Addresses

Primary practice location

1200 California St
Ste 140
Redlands, CA 92374-2945

Mailing address

1200 California St
Ste 140
Redlands, CA 92374-2945
Phone (909) 792-6000

Other identifiers 1

IdentifierTypeStateIssuer
00A739780MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20040827000386 CA Practitioner - Ophthalmology 8123093705 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of California, Geffen School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1200 California St
Suite 140
Redlands, CA 92374-2946
Phone (909) 792-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
73978CAMDPharmacist
A73978CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anaheim Eye Medical Group Inc Ophthalmology CurrentSince Aug 1, 2004 Accepting new patients
Mohammad Reza Neal MD Inc Ophthalmology CurrentSince Jul 15, 2009 Accepting new patients
California Orbital Consultants, Inc. Ophthalmology CurrentSince Oct 15, 2010 Accepting new patients

Locations

1211 W La Palma Ave
Ste 201
Anaheim, CA 92801
Phone (714) 533-2020

360 San Miguel Dr
Ste 307
Newport Beach, CA 92660
Phone (949) 721-0800

400 Newport Center Dr
Ste 605
Newport Beach, CA 92660
Phone (949) 441-5058

1200 California St
Ste 140
Redlands, CA 92374
Phone (909) 792-6000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2881/brand/1/csg/1/fhir/r4
  • Direct secure messaging: madhu.agarwal.1@2881.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1780609933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CALIFORNIA ST",
            "address_2": "STE 140",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923742945",
            "telephone_number": "909-792-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CALIFORNIA ST",
            "address_2": "STE 140",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923742945",
            "telephone_number": "909-792-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGARWAL",
        "first_name": "MADHU",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A73978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A739780",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.