Individual provider Active NPI

Vinh Mai, D.O.

  • Internal Medicine Physician
  • San Bernardino, CA
National Provider Identifier
1992887293
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A9129 Issued in CA
Practice address
2101 N Waterman Ave
San Bernardino, CA 92404-4836
Phone
(909) 881-4520
Fax
(909) 881-4526
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 20A9129 CA
Hospitalist Physician 208M00000X 20A9129 CA
Internal Medicine Physician 207R00000X 20A9129 CA Primary

Addresses

Primary practice location

2101 N Waterman Ave
San Bernardino, CA 92404-4836

Mailing address

5410 Maryland Way
Suite 300
Brentwood, TN 37027-5064
Phone (615) 377-5652

Other identifiers 1

IdentifierTypeStateIssuer
020A91290OtherCABLUE SHIELD OF CALIFORNIA

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
I20070416000241 CA Practitioner - HospitalistPractitioner - Internal Medicine 5698870996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inpatient Specialists of California PCGroup PAC ID 3476864448, 373 clinicians

Practice addresses (Care Compare)

2101 N Waterman Ave
San Bernardino, CA 92404-4836
Phone (909) 883-8711

Hospital & facility affiliations

  • St Bernardine Medical Center Hospital, San Bernardino, CA, CCN 050129

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A9129CAMDInternal Medicine Physician
9129CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Specialists of California, PC Internal Medicine CurrentSince Apr 1, 2015 Accepting new patients
Cogent Healthcare of California, PC Internal Medicine Past Accepting new patients
Cogent Healthcare of California, PC Internal Medicine Past Accepting new patients

Locations

2309 Antonio Ave
Camarillo, CA 93010
Phone (805) 389-5655

155 Glasson Way
Grass Valley, CA 95945
Phone (530) 274-6000

2101 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 881-4305

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1992887293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 MARYLAND WAY",
            "address_2": "SUITE 300",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275064",
            "telephone_number": "615-377-5652",
            "fax_number": "888-241-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 N WATERMAN AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044836",
            "telephone_number": "909-881-4520",
            "fax_number": "909-881-4526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAI",
        "first_name": "VINH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "20A9129",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "20A9129",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A9129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "020A91290",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.