Individual provider Active NPI

Ruth Manjula Karunananthan, M.D.

  • Internal Medicine Physician
  • West Covina, CA
National Provider Identifier
1922057256
Registry record updated Nov 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A64387 Issued in CA
Practice address
1500 W West Covina Pkwy
Ste 102
West Covina, CA 91790-2703
Phone
(626) 263-7010
Fax
(626) 960-3634
NPI assigned
May 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A64387 CA Primary

Addresses

Primary practice location

1500 W West Covina Pkwy
Ste 102
West Covina, CA 91790-2703

Mailing address

1500W West Covina Pkwy
Ste 203
West Covina, CA 91790-2703
Phone (626) 430-9993

Other identifiers 1

IdentifierTypeStateIssuer
00A368060MedicaidCA

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
I20100521000599 CA Practitioner - Internal Medicine 9638208176 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeside Medical Organization a Medical Group IncGroup PAC ID 7618005166, 64 clinicians

Practice addresses (Care Compare)

1500 W W Covina Pkwy
West Covina, CA 91790-2708
Phone (626) 430-9991

Merit-based Incentive Payment System (MIPS)

Final score
80.57 of 100Reported as group
Quality
62.42
Promoting interoperability
76
Improvement activities
40
Cost
76.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64387CAMDPharmacist
A64387CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Medical Organization, a Medical Group Inc. Internal Medicine CurrentSince Mar 17, 2010 Accepting new patients
Lakeside Medical Associates, a Medical Group, Inc. Past Accepting new patients
Lakeside Medical Associates, a Medical Group, Inc. Internal Medicine Past Accepting new patients

Locations

777 Flower St
Ste A
Glendale, CA 91201
Phone (818) 637-2000

8510 Balboa Blvd
Ste 150
Northridge, CA 91325
Phone (818) 637-2000

1500 W West Covina Pkwy
Ste 102
West Covina, CA 91790
Phone (818) 295-5920

1500 W West Covina Pkwy
Ste 203
West Covina, CA 91790
Phone (626) 263-7030

1500 W West Covina Pkwy
West Covina, CA 91790
Phone (626) 430-9991

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ruth.karunananthan.p1@direct.lakeside.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447372800000",
    "number": "1922057256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500W WEST COVINA PKWY",
            "address_2": "STE 203",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902703",
            "telephone_number": "626-430-9993",
            "fax_number": "626-960-8621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W WEST COVINA PKWY",
            "address_2": "STE 102",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902703",
            "telephone_number": "626-263-7010",
            "fax_number": "626-960-3634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARUNANANTHAN",
        "first_name": "RUTH",
        "middle_name": "MANJULA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2015-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A64387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A368060",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.