Individual provider Active NPI

Krishna Murthy, MD

  • Psychiatry Physician
  • Patton, CA
National Provider Identifier
1790725752
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A44250 Issued in CA
Practice address
3102 East Highland Ave
Patton, CA 92369
Phone
(909) 425-7000
Fax
(909) 425-7520
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A44250 CA Primary

Addresses

Primary practice location

3102 East Highland Ave
Patton, CA 92369

Mailing address

1600 9TH Street
Room 205 Mailstop 2-3
Sacramento, CA 95814-6414
Phone (916) 654-2431

Other names 1

  • Chickkaveera Badriah Krishna Murthy Former name

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
I20031110000611 CA Practitioner - Psychiatry 5597678102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of San BernardinoGroup PAC ID 3870499130, 76 clinicians

Practice addresses (Care Compare)

18818 US Hwy 18
Apple Valley, CA 92307-2323
Phone (760) 995-8800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A44250CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Bernardino Current Accepting new patients
County of San Bernardino CurrentSince May 17, 2018 Accepting new patients
State of California - Department of Developmental Services Past Accepting new patients
Corwin Medical Group Inc Ipa PastSince Aug 25, 2010 Accepting new patients

Locations

18818 US Highway 18
Apple Valley, CA 92307
Phone (760) 995-8800

303 E Vanderbilt Way
Sn Bernrdno, CA 92415
Phone (909) 388-0801

12625 Hesperia Rd
Victorville, CA 92395
Phone (760) 955-1777

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1790725752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 9TH STREET",
            "address_2": "ROOM 205 MAILSTOP 2-3",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958146414",
            "telephone_number": "916-654-2431",
            "fax_number": "916-654-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3102 EAST HIGHLAND AVE",
            "city": "PATTON",
            "state": "CA",
            "postal_code": "92369",
            "telephone_number": "909-425-7000",
            "fax_number": "909-425-7520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURTHY",
        "first_name": "KRISHNA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2024-03-04",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A44250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHICKKAVEERA BADRIAH",
            "last_name": "KRISHNA MURTHY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Patton, CA

Sources for this page

Verify at the official NPI Registry.