Jasvir K. Ajit-Uppal, MD
Individual provider Active NPI Cardiovascular Disease Physician · Fontana, CA
NPI 1811056575 · NPPES record last updated Sep 23, 2008
Key facts
- NPI
- 1811056575
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- A49427 (CA)
- Practice address
- 9961 Sierra Ave
Fontana, CA 92335-6720 - Phone
- (909) 427-3910
- NPI assigned
- Dec 8, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240409001064 | CA | Practitioner - Internal Medicine |
8820160716 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49427 | CA | MD | Marriage & Family Therapist |
| A49427 | CA | MD | Cardiovascular Disease Physician |
Practice roles (1 of 2)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Systems, Inc. | Current |
Accepting new patients |
Locations
22675 Alessandro Blvd
Moreno Valley, CA 92553
Phone (951) 571-2300
21801 Alessandro Blvd
Moreno Valley, CA 92553
Phone (951) 571-2300
2933 University Ave
Riverside, CA 92507
Phone (951) 224-8220
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- jasvir.ajituppal.p1@direct.chsica.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | A49427 | CA | Yes |
Addresses
Primary practice location
9961 Sierra Ave
Fontana, CA 92335-6720
Mailing address
9961 Sierra Ave
Fontana, CA 92335-6720
Phone (909) 427-3910
Other providers in Fontana, CA
- Samuel T Ahn
- Beverly Ahoni
- Saveen Ahuja
- Joachim Ikponmwosa Airen
- Martha C Ajca
- Paul K. Aka
- Imad Akel
- Dedra P. Akins
- Aklan Meadows, Inc
- Aklan Meadows, Inc.
All providers in Fontana, CA · Cardiovascular Disease Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.