Active NPI
Pramod Theetha Kariyanna, M.D.
- Interventional Cardiology Physician
- Pomona, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Cardiology Physician
- License
- A183121
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, MT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 3
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
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
- Providence Santa Rosa Memorial Hospital
- St Peters Health
Merit-based Incentive Payment System (MIPS)
- Final score
- 78.08 of 100
- Quality
- 40.87
- Promoting interoperability
- 75
- Improvement activities
- 40
- Cost
- 74.84
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A183121 | CA | MD | Interventional Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Medical Foundation | Current | Accepting new patients | |
| Marshfield Clinic Inc | Current | Accepting new patients | |
| Chaparral Medical Group, Inc. | Current | Accepting new patients | |
| MCHS Hospitals Inc | Current | Accepting new patients | |
| Chaparral Medical Group Inc. | Current | Accepting new patients | |
| Chaparral Medical Group Inc. | Current | Accepting new patients | |
| MCHS Hospitals Inc | Current | Accepting new patients | |
| Chaparral Medical Group, Inc. | Current | Accepting new patients | |
| Providence Medical Foundation | Current | Accepting new patients | |
| Providence Medical Foundation | Current | Accepting new patients | |
| MCHS Hospitals Inc | Current | 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
- ptheethakariyanna4104383@oc.providencedirect.org
- 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.
-
- Family Medicine Physician
- Brea, CA
- NPI 1871607762
-
- General Acute Care Hospital
- Helena, MT
- NPI 1205025145
-
- Dermatology Physician
- Rancho Cucamonga, CA
- NPI 1093777666
-
- Orthopaedic Surgery Physician
- Pomona, CA
- NPI 1477733624
-
- Clinic/Center
- Marshfield, WI
- NPI 1952347981
-
- Clinic/Center
- Marshfield, WI
- NPI 1093221434
-
- Cardiovascular Disease Physician
- Upland, CA
- NPI 1639869605
-
- Gastroenterology Physician
- Upland, CA
- NPI 1780146019
-
- Obstetrics & Gynecology Physician
- Napa, CA
- NPI 1205131950
-
- General Practice Physician
- Diamond Bar, CA
- NPI 1285890624
-
- Family Medicine Physician
- Anaheim, CA
- NPI 1639715709
-
- Durable Medical Equipment & Medical Supplies
- Eau Claire, WI
- NPI 1558230847
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Santa Rosa, CA
- NPI 1134152549
-
- Home Infusion Therapy Pharmacy
- Eureka, CA
- NPI 1568422319
Hospital
-
- General Acute Care Hospital
- Eureka, CA
- NPI 1609858950
-
- General Acute Care Hospital
- Eureka, CA
- NPI 1891900635
-
- General Acute Care Hospital
- Helena, MT
- NPI 1528023520
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.