Active NPI
Archana Bangalore
- Family Medicine Physician
- Clovis, CA
National Provider Identifier
1801349683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A157666
- Practice address
- 180 W Shaw Ave
Clovis, CA 93612-3746 - Phone
- (559) 203-6600
- NPI assigned
- Jul 28, 2016
- Last updated
- Aug 26, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A157666 | CA | Primary |
Addresses
Primary practice location
180 W Shaw Ave
Clovis, CA 93612-3746
Mailing address
21890 W Colorado Avenue
San Joaquin, CA 93660
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191108002858 | CA | Order and Referring Only - Family Practice | 5991137135 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A157666 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Health Team, Inc | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- archana.bangalore.p4@direct.vht.nextgenshare.com
Organizations & group practices 1
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.
-
dba Kerman Health Center
- Federally Qualified Health Center (FQHC)
- Kerman, CA
- NPI 1962567388
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566777600000",
"number": "1801349683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21890 W COLORADO AVENUE",
"city": "SAN JOAQUIN",
"state": "CA",
"postal_code": "93660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 W SHAW AVE",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936123746",
"telephone_number": "559-203-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANGALORE",
"first_name": "ARCHANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-28",
"last_updated": "2019-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A157666",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clovis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.