Individual provider Active NPI

Parvathi Tiruviluamala, MD

  • Specialist
  • San Diego, CA
National Provider Identifier
1982798948
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A79302 Issued in CA
Practice address
5555 Reservoir Dr
201
San Diego, CA 92120-5134
Phone
(858) 866-0245
Fax
(858) 866-0249
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A79302 CA Primary

Addresses

Primary practice location

5555 Reservoir Dr
201
San Diego, CA 92120-5134

Mailing address

14202 Eden GRV
Poway, CA 92064-2379
Phone (619) 417-4535

Other identifiers 1

IdentifierTypeStateIssuer
00A793020OtherCAMEDI-CAL

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
I20040927000709 CA Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary Disease 6406825579 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A79302CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
KND Development 59, LLC CurrentSince Feb 1, 2019 Accepting new patients
KND Development 59 LLC Current Accepting new patients
KND Development 59 LLC CurrentSince Feb 1, 2019 Accepting new patients
Larry I. Emdur, D.O., PHD. Specialist Past Accepting new patients

Locations

4940 El Cajon Blvd
San Diego, CA 92115
Phone (619) 543-4500

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204156800000",
    "number": "1982798948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14202 EDEN GRV",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642379",
            "telephone_number": "619-417-4535",
            "fax_number": "858-866-0249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 RESERVOIR DR",
            "address_2": "201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205134",
            "telephone_number": "858-866-0245",
            "fax_number": "858-866-0249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIRUVILUAMALA",
        "first_name": "PARVATHI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A79302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "00A793020",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.