Individual provider Active NPI

Bhanu Sud, MD

  • Infectious Disease Physician
  • Placentia, CA
National Provider Identifier
1972643344
Registry record updated Mar 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
C52777 Issued in CA
Practice address
1275 N Rose Dr
Suite 134
Placentia, CA 92870-3941
Phone
(714) 996-6500
Fax
(714) 996-1722
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X C52777 CA Primary

Addresses

Primary practice location

1275 N Rose Dr
Suite 134
Placentia, CA 92870-3941

Mailing address

1275 N Rose Dr
Suite 134
Placentia, CA 92870-3941
Phone (714) 996-6500

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
I20080501000518 CA Practitioner - Infectious DiseasePractitioner - Internal Medicine 8325127319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Petreccia and Trotter Medical CorporationGroup PAC ID 7315026309, 3 clinicians

Practice addresses (Care Compare)

1275 N Rose Dr
Placentia, CA 92870-3919
Phone (714) 996-6500

Hospital & facility affiliations

  • Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168
  • Uci Health-Orange Hospital, Orange, CA, CCN 050348

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C52777CAMDInfectious Disease Physician
52777CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Petreccia and Trotter Medical Corporation Infectious Disease CurrentSince Dec 17, 2007 Accepting new patients
University of California Irvine Past Accepting new patients
St Jude Hospital Inc Past Accepting new patients
THC - Orange County, LLC Past Accepting new patients

Locations

1275 N Rose Dr
Ste 134
Placentia, CA 92870
Phone (714) 996-6500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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 4

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": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269216000000",
    "number": "1972643344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 N ROSE DR",
            "address_2": "SUITE 134",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928703941",
            "telephone_number": "714-996-6500",
            "fax_number": "714-996-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 N ROSE DR",
            "address_2": "SUITE 134",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928703941",
            "telephone_number": "714-996-6500",
            "fax_number": "714-996-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUD",
        "first_name": "BHANU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2010-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "C52777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placentia, CA

Sources for this page

Verify at the official NPI Registry.