Individual provider Active NPI

Konstantinos Vlachonassios, M.D.

  • Cardiovascular Disease Physician
  • Lakewood, CA
National Provider Identifier
1851473003
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A52738 Issued in CA
Practice address
3300 E South St Ste 301
Lakewood, CA 90805-4561
Phone
(562) 622-9500
Fax
(562) 622-9513
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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 A52738 CA Primary

Addresses

Primary practice location

3300 E South St Ste 301
Lakewood, CA 90805-4561

Mailing address

19051 Goldenwest St # 106-321
Huntington Beach, CA 92648-2155
Phone (562) 622-9500

Other identifiers 1

IdentifierTypeStateIssuer
00A5278380MedicaidCA

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
I20050825000849 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Other (Physician) 0345270328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11101 La Reina Ave
Suite 201
Downey, CA 90241-4237
Phone (562) 622-9500

Hospital & facility affiliations

  • Uci Health-Lakewood Hospital, Lakewood, CA, CCN 050581
  • Uci Health-Orange Hospital, Orange, CA, CCN 050348
  • Pih Health Downey Hospital Hospital, Downey, CA, CCN 050393
  • Pih Health Hospital-Whittier Hospital, Whittier, CA, CCN 050169

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting15
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A52738CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Konstantinos Vlachonassios MD Inc Cardiovascular Disease CurrentSince Jun 1, 2004 Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Pih Health Downey Hospital Past Accepting new patients
University of California Irvine Past Accepting new patients
Pih Health Whittier Hospital Past Accepting new patients

Locations

11101 La Reina Ave
#201
Downey, CA 90241
Phone (562) 622-9500

3300 E South St
Ste 301
Lakewood, CA 90805
Phone (562) 622-9500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kvlachonassios@konstantinosvlachonassiosmdinc.amazing-direct.com
  • Direct secure messaging: rabellar@konstantinosvlachonassiosmdinc.amazing-direct.com

Organizations & group practices 5

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 5

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1851473003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19051 GOLDENWEST ST # 106-321",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926482155",
            "telephone_number": "562-622-9500",
            "fax_number": "562-622-9513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 E SOUTH ST STE 301",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "908054561",
            "telephone_number": "562-622-9500",
            "fax_number": "562-622-9513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VLACHONASSIOS",
        "first_name": "KONSTANTINOS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A52738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A5278380",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

Verify at the official NPI Registry.