Individual provider Active NPI

Vinod M Assomull Sr., MD

  • Nephrology Physician
  • Granada Hills, CA
National Provider Identifier
1982619359
Registry record updated Jan 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A31336 Issued in CA
Practice address
10605 Balboa Blvd
240
Granada Hills, CA 91344-6342
Phone
(661) 254-0193
Fax
(661) 254-2248
NPI assigned
Jul 31, 2006
Last updated
Jan 28, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A31336 CA Primary

Addresses

Primary practice location

10605 Balboa Blvd
240
Granada Hills, CA 91344-6342

Mailing address

16809 Oak View Dr
Encino, CA 91436-3239

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
I20101015001081 CA Practitioner - Internal MedicinePractitioner - Nephrology 7719957950 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Renal Consultants Medical Group Nephrology CurrentSince Jan 1, 1973 Accepting new patients
Northridge Vascular Center a Professional Medical Corporation PastSince Apr 30, 2015 Accepting new patients
Northridge Kidney Care Center LLC PastSince Aug 24, 2015 Accepting new patients

Locations

10605 Balboa Blvd
Ste 240
Granada Hills, CA 91344
Phone (818) 366-3935

16907 Devonshire St
Granada Hills, CA 91344
Phone (805) 254-0193

23928 Lyons Ave
Ste 105
Newhall, CA 91321
Phone (661) 254-0193

23928 Lyons Ave
Ste 205
Newhall, CA 91321
Phone (661) 254-0193

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390867200000",
    "number": "1982619359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16809 OAK VIEW DR",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914363239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10605 BALBOA BLVD",
            "address_2": "240",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913446342",
            "telephone_number": "661-254-0193",
            "fax_number": "661-254-2248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASSOMULL",
        "first_name": "VINOD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2014-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A31336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granada Hills, CA

Sources for this page

Verify at the official NPI Registry.