Individual provider Active NPI

Pramod Theetha Kariyanna, M.D.

  • Interventional Cardiology Physician
  • Pomona, CA
National Provider Identifier
1881005809
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
A183121 Issued in CA
Practice address
790 E Bonita Ave FL 2
Pomona, CA 91767-1906
Phone
(909) 447-8585
Fax
(909) 447-8593
NPI assigned
May 13, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NY
Interventional Cardiology Physician 207RI0011X A183121 CA Primary

Addresses

Primary practice location

790 E Bonita Ave FL 2
Pomona, CA 91767-1906

Mailing address

840 Towne Center Dr
Pomona, CA 91767-5900
Phone (909) 398-1550

Other practice location 1

8330 Red Oak St Ste 101
Rancho Cucamonga, CA 91730-0603
Phone (909) 987-4922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, CA, MT3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210721001665 WI Practitioner - Interventional Cardiology 5193062040 Reassigns benefits to 2 organizations
I20230103002829 CA Practitioner - Interventional Cardiology 5193062040 Reassigns benefits to 3 organizations
I20260520000086 MT Practitioner - Interventional Cardiology 5193062040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Peters HealthGroup PAC ID 7911814926, 206 clinicians
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

2475 E Broadway St
Helena, MT 59601-4928
Phone (406) 447-2828

2773 Harris St
Suite a
Eureka, CA 95503-4866
Phone (707) 267-2070

Hospital & facility affiliations

  • Providence St Joseph Hospital Hospital, Eureka, CA, CCN 050006
  • Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174
  • St Peters Health Hospital, Helena, MT, CCN 270003

Merit-based Incentive Payment System (MIPS)

Final score
78.08 of 100Reported as group
Quality
40.87
Promoting interoperability
75
Improvement activities
40
Cost
74.84

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A183121CAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Marshfield Clinic Inc CurrentSince Jul 26, 2021 Accepting new patients
Chaparral Medical Group, Inc. CurrentSince Dec 1, 2022 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Chaparral Medical Group Inc. CurrentSince Dec 1, 2022 Accepting new patients
Chaparral Medical Group Inc. CurrentSince Dec 1, 2022 Accepting new patients
MCHS Hospitals Inc CurrentSince Jul 26, 2021 Accepting new patients
Chaparral Medical Group, Inc. Current Accepting new patients
Providence Medical Foundation CurrentSince Oct 1, 2025 Accepting new patients
Providence Medical Foundation CurrentSince Oct 1, 2025 Accepting new patients
MCHS Hospitals Inc CurrentSince Jul 26, 2021 Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

2773 Harris St
Ste A
Eureka, CA 95503
Phone (707) 442-1182

1801 W Olympic Blvd
Pasadena, CA 91199

1866 N Orange Grove Ave
Ste 202
Pomona, CA 91767
Phone (909) 623-8796

790 E Bonita Ave
Fl 2
Pomona, CA 91767
Phone (909) 447-8585

840 Towne Center Dr
Pomona, CA 91767

9190 Haven Ave
Ste 101
Rancho Cucamonga, CA 91730
Phone (909) 581-6732

8330 Red Oak St
Ste 101
Rancho Cucamonga, CA 91730
Phone (909) 987-4922

8330 Red Oak St
Ste 201
Rch Cucamonga, CA 91730
Phone (909) 987-1730

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

1165 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 525-5300

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

585 N Mountain Ave
Ste A
Upland, CA 91786
Phone (909) 608-7546

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ptheethakariyanna4104383@oc.providencedirect.org
  • Direct secure messaging: pramod.theethakariyanna@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 8

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": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1881005809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 TOWNE CENTER DR",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675900",
            "telephone_number": "909-398-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 E BONITA AVE FL 2",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671906",
            "telephone_number": "909-447-8585",
            "fax_number": "909-447-8593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8330 Red Oak St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "917300603",
            "country_code": "US",
            "telephone_number": "909-987-4922",
            "fax_number": "909-466-1190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THEETHA KARIYANNA",
        "first_name": "PRAMOD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-13",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A183121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.