DR. VIJAY RAVEENDRAN POTTATHIL M.D.
NPI 1053546945
Internal Medicine - Gastroenterology in Stanford, CA
About Dr. Vijay Raveendran Pottathil M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. VIJAY RAVEENDRAN POTTATHIL M.D. (NPI 1053546945) is an individual gastroenterology provider in Stanford, California, licensed in California (A147576) and active in the NPI registry since May 2009. He is enrolled in Medicare PECOS and is a graduate of University Of Michigan Medical School (2009).
NPPES Registry Identity
Specialties & Licenses 3
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Vijay Raveendran Pottathil M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Vijay Pottathil reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Menlo Park, CA 94025
- Reassigned Medicare billing, California enrollment
- Also billed through NPI 1831268580 (California)
- 597 clinicians in this Medicare group
Belmont, CA 94002
- Reassigned Medicare billing, California enrollment
- 1,191 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 4
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 94305 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
STANFORD, CA 94305
STANFORD, CA 94305
STANFORD, CA 94305
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Vijay Pottathil's NPI number?
The NPI number for Vijay Pottathil is 1053546945. It was assigned to this individual provider in the NPPES registry on May 20, 2009.
Where is Vijay Pottathil located?
Vijay Pottathil practices at 300 Pasteur Dr, Stanford, CA 94305. The listed phone number is (650) 723-4000.
What is Vijay Pottathil's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.
Is Vijay Pottathil enrolled in Medicare?
Yes. Vijay Pottathil is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Vijay Pottathil's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Vijay Pottathil reassigns Medicare benefits to 2 organizations: County Of San Mateo (Menlo Park, CA) and Dignity Health Medical Foundation (Belmont, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Vijay Pottathil's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Vijay Pottathil was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Vijay Raveendran Pottathil, M.D. · NPI 1053546945
Gastroenterology physician in Stanford, California. Individual provider, active in the CMS NPPES registry since May 20, 2009.
## Identity
- **NPI:** 1053546945 (Entity type: Individual)
- **Enumerated:** May 20, 2009
- **Primary specialty:** Internal Medicine - Gastroenterology · taxonomy 207RG0100X
- **State license:** A147576 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 300 PASTEUR DR, Stanford, CA 94305-2200
- **Phone:** (650) 723-4000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): County Of San Mateo (NPI 1336239052, Menlo Park, CA); Dignity Health Medical Foundation (NPI 1174531859, Belmont, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Michigan Medical School, class of 2009
## Record status
- **NPPES last updated:** July 21, 2022
- **Other identifiers:** Medicaid 1053546945 (IA)
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Source: [NPI Profile](https://npiprofile.com/npi/1053546945) · Data from the CMS NPPES public registry.