Vijay Krishna Prabhakar, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

A144053 Issued in CA

Practice address

1837 Sunny Crest Dr
Fullerton, CA 92835-3616

Phone

(714) 446-5831

NPI assigned

Mar 25, 2015

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

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

Specialty

Internal MedicineAlso: Gastroenterology

Education

Duke University School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: vprabhakar2927600@oc.providencedirect.org

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD (past)
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1609925957
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• Stanford Health Care

  dba Stanford Medical Center A Trade Name for Stanford Health Care

  • General Acute Care Hospital
  • Stanford, CA
  • NPI 1437292927

  Internal Medicine

  NPD
• Lucile Salter Packard Children'S Hospital at Stanford

  • Children's Hospital
  • Palo Alto, CA
  • NPI 1467442749
  NPD (past)
• St Jude Hospital Inc

  dba Providence St. Jude Medical Center

  • General Acute Care Hospital
  • Fullerton, CA
  • NPI 1194926279
  NPD (past)
• Stanford Hospital and Clinics

  dba SHC Reference Laboratory

  • Clinical Medical Laboratory
  • Palo Alto, CA
  • NPI 1174698468
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Jude Hospital Inc

  dba Providence St. Jude Medical Center

  • General Acute Care Hospital
  • Fullerton, CA
  • NPI 1194926279
  Care Compare affiliation
• St Jude Hospital Inc

  dba Providence St. Jude Medical Center

  • General Acute Care Hospital
  • Brea, CA
  • NPI 1891904942
  Care Compare affiliation

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

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1932593167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1837 SUNNY CREST DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353616",
            "telephone_number": "714-446-5831",
            "fax_number": "714-446-7910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1837 SUNNY CREST DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353616",
            "telephone_number": "714-446-5831"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15855 Pomona Rincon Rd",
            "address_purpose": "LOCATION",
            "city": "Chino Hills",
            "state": "CA",
            "postal_code": "917095572",
            "country_code": "US",
            "telephone_number": "714-446-5831",
            "fax_number": "714-446-7910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRABHAKAR",
        "first_name": "VIJAY",
        "middle_name": "KRISHNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-25",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A144053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pour Monajem Zadeh Dental Fullerton Inc
• Anahita Pourmanouchehri
• Malina Powell
• Rebecca Powell
• Robert Powell
• Dannic Prado
• Priscilla Prado
• Keri Marie Prather, LMFT
• Preciado Rocha Chiropractic Corporation (PR Chiropractic)
• Benji Preciado Rocha, DC

• Gastroenterology Physician in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.

Verify at the official NPI Registry.