Individual provider Active NPI

Sanjay M. Vaswani, MD

  • Psychiatry Physician
  • Cerritos, CA
National Provider Identifier
1982752952
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A75912 Issued in CA
Practice address
12900 Park Plaza Dr
Cerritos, CA 90703-9329
Phone
(800) 407-4627
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A75912 CA Primary

Addresses

Primary practice location

12900 Park Plaza Dr
Cerritos, CA 90703-9329

Mailing address

617 Poplar St
Fullerton, CA 92835-4423
Phone (949) 302-0252

Other identifiers 1

IdentifierTypeStateIssuer
00A759120MedicaidCA

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
I20050722000428 CA Practitioner - Psychiatry 2163459991 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1989
Medicare assignment
May accept Medicare assignment
Group practices
Clinicas de Salud del Pueblo IncGroup PAC ID 5496657082, 42 clinicians

Practice addresses (Care Compare)

223 W Cole Blvd
Calexico, CA 92231-9722
Phone (760) 357-2020

852 E Danenberg Dr
El Centro, CA 92243-3320

852 E Danenberg Dr
El Centro, CA 92243-8517
Phone (760) 356-2225

900 Main St
Brawley, CA 92227-2630
Phone (760) 344-6471

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A75912CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mission City Community Network, Inc. Current Accepting new patients
Clinicas de Salud del Pueblo Inc. CurrentSince Nov 18, 2019 Accepting new patients
Mission City Community Network, Inc. CurrentSince May 16, 2022 Accepting new patients
Clinicas de Salud del Pueblo, Inc CurrentSince Nov 18, 2019 Accepting new patients
Clinicas de Salud del Pueblo, Inc Current Accepting new patients
Mission City Community Network, Inc. CurrentSince May 16, 2022 Accepting new patients

Locations

223 W Cole Blvd
Calexico, CA 92231
Phone (760) 357-2020

852 E Danenberg Dr
El Centro, CA 92243
Phone (760) 352-2257

15206 Parthenia St
Sepulveda, CA 91343

Interoperability endpoints

  • Direct secure messaging: sanjay.vaswani.p1@direct.cdsdp.nextgenshare.com

Organizations & group practices 6

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1982752952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 POPLAR ST",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928354423",
            "telephone_number": "949-302-0252",
            "fax_number": "866-878-4621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12900 PARK PLAZA DR",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907039329",
            "telephone_number": "800-407-4627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASWANI",
        "first_name": "SANJAY",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A75912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A759120",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

Verify at the official NPI Registry.