Individual provider Active NPI

Paiboon Mahaisavariya, M.D.

  • Cardiovascular Disease Physician
  • Downey, CA
National Provider Identifier
1801959069
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
G66961 Issued in CA
Practice address
8317 Davis Street
Suite a
Downey, CA 90241-5021
Phone
(562) 869-1511
Fax
(562) 869-0771
NPI assigned
Dec 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X G66961 CA Primary

Addresses

Primary practice location

8317 Davis Street
Suite a
Downey, CA 90241-5021

Mailing address

8317 Davis Street
Suite a
Downey, CA 90241-5021
Phone (562) 869-1511

Other identifiers 2

IdentifierTypeStateIssuer
00G669610MedicaidCA
060068099OtherCAMEDICARE RAILROAD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aide@cvma.care

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
I20100820000999 CA Practitioner - Cardiovascular Disease (Cardiology) 0446384754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Southern California Keck School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaushal R Tamboli MD IncGroup PAC ID 2365473295, 4 clinicians

Practice addresses (Care Compare)

3628 E Imperial Hwy
Suite 201
Lynwood, CA 90262-2646
Phone (562) 869-1511

8317 Davis St
Suite a
Downey, CA 90241-4918
Phone (562) 869-1511

8317 Davis St a
Downey, CA 90241-4918

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.59 of 100Reported as group
Quality
75.18
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G66961CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaushal R Tamboli MD Inc Cardiovascular Disease CurrentSince Jul 1, 2010 Accepting new patients
University of California Irvine Past Accepting new patients
St Francis Medical Center Past Accepting new patients
Pih Health Downey Hospital Past Accepting new patients

Locations

11411 Brookshire Ave
Ste 403
Downey, CA 90241
Phone (562) 869-1511

8317 Davis St
Apt A
Downey, CA 90241
Phone (562) 869-1511

3628 E Imperial Hwy
Ste 201
Lynwood, CA 90262
Phone (310) 406-3900

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.

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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1801959069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8317 DAVIS STREET",
            "address_2": "SUITE A",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902415021",
            "telephone_number": "562-869-1511",
            "fax_number": "562-869-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8317 DAVIS STREET",
            "address_2": "SUITE A",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902415021",
            "telephone_number": "562-869-1511",
            "fax_number": "562-869-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAISAVARIYA",
        "first_name": "PAIBOON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G66961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G669610",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "060068099",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aide@cvma.care",
            "affiliation": "N",
            "address_1": "8317 Davis Street",
            "address_2": "Suite A",
            "city": "Downey",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902415021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

Verify at the official NPI Registry.