NPIMap

Individual provider Active NPI

Prashanth Vasantha Kumar, M.D.

  • Nephrology Physician
  • Victorville, CA
National Provider Identifier
1821293382
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A102091 Issued in CA
Practice address
12675 Hesperia Rd
Victorville, CA 92395-5878
Phone
(760) 241-3306
Fax
(760) 241-5037
NPI assigned
Jun 15, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A102091 CA Primary
Internal Medicine Physician 207R00000X A102091 CA

Addresses

Primary practice location

12675 Hesperia Rd
Victorville, CA 92395-5878

Mailing address

12675 Hesperia Rd
Victorville, CA 92395-5878
Phone (760) 241-3306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090317000183 CA Practitioner - NephrologyPractitioner - Internal Medicine 7416014519 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Wayne State University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ridgecrest Regional HospitalGroup PAC ID 9739099896, 94 clinicians
High Desert Nephrology Medical Associates IncGroup PAC ID 2860439288, 6 clinicians
Desert Valley Medical Group IncGroup PAC ID 4880595875, 78 clinicians

Practice addresses (Care Compare)

105 E Sydnor Ave
Suite 100
Ridgecrest, CA 93555-5546
Phone (760) 446-6404

12675 Hesperia Rd
Victorville, CA 92395-5878
Phone (760) 241-3306

16850 Bear Valley Rd
Victorville, CA 92395-5794
Phone (760) 241-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A102091CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgecrest Regional Hospital CurrentSince Apr 1, 2025 Accepting new patients
High Desert Nephrology Medical Associates, Inc. Nephrology CurrentSince Jun 30, 2008 Accepting new patients
Ridgecrest Regional Hospital Current Accepting new patients
Ridgecrest Regional Hospital Internal Medicine CurrentSince Apr 1, 2025 Accepting new patients
High Desert Nephrology Medical Associates Inc. Nephrology Past Accepting new patients

Locations

655 S 7th Ave
Barstow, CA 92311
Phone (760) 255-3376

1041 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-0121

105 E Sydnor Ave
Ste 204
Ridgecrest, CA 93555

1081 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-0616

1111 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-4571

11883 Amethyst Rd
Victorville, CA 92392
Phone (760) 241-8063

11883 Amethyst Rd
Ste 100
Victorville, CA 92392
Phone (661) 272-3777

12675 Hesperia Rd
Victorville, CA 92395
Phone (760) 241-3306

16850 Bear Valley Rd
Victorville, CA 92395
Phone (760) 241-8222

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: pkumar02@yourcarecommunity.org
  • Direct secure messaging: pkumar25174@direct.acumenmd.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Providence St. Mary Medical CenterApple Valley, CA, CCN 050300 Hospital Corporate Director Jan 1, 2024

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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.

Hospital & facility affiliations 10

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": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1821293382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12675 HESPERIA RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955878",
            "telephone_number": "760-241-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12675 HESPERIA RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955878",
            "telephone_number": "760-241-3306",
            "fax_number": "760-241-5037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "PRASHANTH",
        "middle_name": "VASANTHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-15",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A102091",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A102091",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.