NPIMap

Individual provider Active NPI

Nikhil Thiruvengadam

  • Gastroenterology Physician
  • Loma Linda, CA
National Provider Identifier
1972923431
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A147956 Issued in CA
Practice address
11234 Anderson St # Mc1516
Loma Linda, CA 92354-2804
Phone
(909) 558-4499
Fax
(909) 558-0428
NPI assigned
Apr 23, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A147956 CA Primary

Addresses

Primary practice location

11234 Anderson St # Mc1516
Loma Linda, CA 92354-2804

Mailing address

5400 Avenida del Tren
Yorba Linda, CA 92887-4900
Phone (714) 926-1901

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200415003546 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 6901105386 Reassigns benefits to 1 organization
I20200831002531 PA Practitioner - Gastroenterology 6901105386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Stanford University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

11234 Anderson St
Loma Linda, CA 92354-2804

11370 Anderson St
Loma Linda, CA 92354-3450

26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone (951) 486-4000

26780 Barton Rd
Redlands, CA 92373-4308
Phone (909) 558-5174

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy30
Upper gastrointestinal (GI) endoscopy for acid reflux261

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group Gastroenterology CurrentSince Jul 1, 2020 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Aug 1, 2021 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2020 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Presbyterian Medical Center of the University of Pennsylvania Health S Past Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Presbyterian Medical Center of the University of Pennsylvania Health S Past Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients
Loma Linda University Children'S Hospital Past Accepting new patients
The Pennsylvania Hospital of the University of Pennsylvania Health Sys Past Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients

Locations

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

3400 Spruce St
Fl 3
Philadelphia, PA 19104

3400 Civic Center Blvd
#4
Philadelphia, PA 19104
Phone (215) 614-1618

3400 Spruce St
Rm 100
Philadelphia, PA 19104
Phone (215) 662-2200

Interoperability endpoints

  • Direct secure messaging: nthiruvengadam402230@direct.llu.edu

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 3

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": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1972923431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 AVENIDA DEL TREN",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928874900",
            "telephone_number": "714-926-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST # MC1516",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4499",
            "fax_number": "909-558-0428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIRUVENGADAM",
        "first_name": "NIKHIL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-23",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A147956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.