AMBARISH MUKUND ATHAVALE MD
NPI 1255647145
Internal Medicine - Nephrology in San Diego, CA

Q: What is Ambarish Athavale's NPI number?

The NPI number for Ambarish Athavale is 1255647145. It was assigned to this individual provider in the NPPES registry on August 30, 2010.

Q: What is Ambarish Athavale's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Q: When was this NPI record last updated?

The NPPES record for Ambarish Athavale was last updated on May 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since August 30, 2010PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

200 W ARBOR DR, SAN DIEGO, CA 92103(800) 926-8273(888) 539-8781 Get Directions Write a Review

NPPES record last updated: May 3, 2024. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: May 3, 2024, Apr 21, 2021, Jul 13, 2020 (3 updates tracked since 2020).

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About Ambarish Mukund Athavale Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AMBARISH MUKUND ATHAVALE MD (NPI 1255647145) is an individual nephrology provider in San Diego, California, licensed in Illinois (036-127463) and active in the NPI registry since August 2010. He is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Other (2002).

NPPES Registry Identity

NPI1255647145

Entity TypeIndividualMale

Primary Taxonomy207RN0300X

Provider Legal NameAMBARISH MUKUND ATHAVALECredential: MD

Location Address200 W ARBOR DRSan Diego, CA 92103-9000

Mailing AddressFile 57326Los Angeles, CA 90074-7326 · (858) 249-6748

Phone(800) 926-8273

Fax(888) 539-8781

Sole ProprietorNo

Medical School CMSOtherGraduated 2002

Enumeration DateAugust 30, 2010

Last NPPES UpdateMay 3, 20243 updates tracked since enumeration

NPPES CertifiedMay 3, 2024

✔ NPI 1255647145 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

License✔ Licensed in IL · 036-127463

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

Also ListedInternal MedicineTaxonomy 207R00000X · License 036-127463 (IL)

200 W ARBOR DR, San Diego, CA 92103

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Secondary Practice Locations 3

Location 11900 W Harrison StChicago, IL 60612-3736 · Phone (312) 864-6000

Location 29350 Campus Point DrLA Jolla, CA 92037-1300 · Phone (800) 926-8273 · Fax (888) 539-8781

Location 39300 Campus Point DrLA Jolla, CA 92037-1300 · Phone (800) 926-8273 · Fax (888) 539-8781

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ambarish Mukund Athavale Md 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.

PECOS PAC ID5092973677

PECOS Enrollment IDI20220916002991

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 11

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

386 services114 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

223 services85 patients

Dialysis services, 4 or more physician visits per month (20 years or older) 90960

Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.

97 services12 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

95 services90 patients

Dialysis services, 2-3 physician visits per month (20 years or older) 90961

Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.

79 services11 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

75 services52 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

43 services26 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

18 services18 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

18 services14 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

15 services14 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$140.22 typical visit price

range $62.10 – $184.71

Typical copayment $35.05 (range $15.52 – $46.17)

Most-billed visit code 99204

Established Patient

$108.42 typical visit price

range $20.62 – $151.42

Typical copayment $27.10 (range $5.15 – $37.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

75/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

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.

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