Vincent Joseph Maddela, M.D.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

A53726 Issued in CA

Practice address

2701 Chester Ave # 201
Bakersfield, CA 93301-2016

Phone

(661) 716-1070

Fax

(661) 716-1075

NPI assigned

Feb 6, 2007

Last updated

Feb 21, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Highgrove Medical Clinic,Inc

  • Specialist
  • Bakersfield, CA
  • NPI 1619968583
  NPD (past)
• Kern Radiology Medical Group, Inc

  • Diagnostic Radiology Physician
  • Bakersfield, CA
  • NPI 1720023997
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361404800000",
    "number": "1851430797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 CHESTER AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933012016",
            "telephone_number": "661-716-9422",
            "fax_number": "661-323-0889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 CHESTER AVE # 201",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933012016",
            "telephone_number": "661-716-1070",
            "fax_number": "661-716-1075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDELA",
        "first_name": "VINCENT",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2013-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "A53726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL GROUP #",
            "identifier": "GR0092950",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "ZZZ01707Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP PROV #",
            "identifier": "ZZZ01800Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emiko Mackins
• Johnetta Nicole Mackins, LVN
• Shannon C Macy, ASSOCIATES
• Margie Madamba, SP
• Tina Madan
• Clayton Powell Madden Jr.
• Beatrice Maddox, SAC
• Denis E Maddox, M.D.
• Nicole Ashley Madera
• Porfirio Madera Jr.

• Adult Medicine Physician in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Adult Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; 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.

Verify at the official NPI Registry.