Individual provider Active NPI

Vanita Mistry

  • Internal Medicine Physician
  • San Jose, CA
National Provider Identifier
1801327010
Registry record updated Sep 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A157556 Issued in CA
Practice address
2400 Moorpark Ave Ste 220B
San Jose, CA 95128-2631
Phone
(888) 334-1000
NPI assigned
Mar 21, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X A157556 CA Primary

Addresses

Primary practice location

2400 Moorpark Ave Ste 220B
San Jose, CA 95128-2631

Mailing address

2400 Moorpark Ave Ste 220B
San Jose, CA 95128-2631
Phone (888) 334-1000

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
I20200626000584 CA Practitioner - Internal Medicine 5890049472 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Arizona College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Santa ClaraGroup PAC ID 1254244973, shared by 46 NPIs, 1,000 clinicians

Practice addresses (Care Compare)

751 S Bascom Ave
San Jose, CA 95128-2604
Phone (408) 885-5000

Hospital & facility affiliations

  • South Springs Home Health Care Home health agency, San Jose, CA, CCN 059620
  • Santa Clara Valley Medical Center Hospital, San Jose, CA, CCN 050038

Merit-based Incentive Payment System (MIPS)

Final score
61 of 100Reported as group
Quality
59.41
Promoting interoperability
0
Improvement activities
40
Cost
71.45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A157556CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Jun 30, 2020 Accepting new patients
County of Santa Clara CurrentSince Jun 30, 2020 Accepting new patients
County of Santa Clara Internal Medicine Current Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara CurrentSince Jun 30, 2020 Accepting new patients
County of Santa Clara CurrentSince Jun 30, 2020 Accepting new patients
County of Santa Clara Current Accepting new patients

Locations

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

2101 Alexian Dr
San Jose, CA 95116
Phone (408) 272-6050

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

2400 Moorpark Ave
Ste 220B
San Jose, CA 95128

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

1996 Lundy Ave
San Jose, CA 95131
Phone (408) 299-5846

660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366

Interoperability endpoints

  • Direct secure messaging: vmistry165700@santaclaravalley.direct-ci.net

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1801327010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 MOORPARK AVE STE 220B",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282631",
            "telephone_number": "888-334-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 MOORPARK AVE STE 220B",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282631",
            "telephone_number": "888-334-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISTRY",
        "first_name": "VANITA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-21",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A157556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.