Nisha K Surenderanath, M.D.

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

0101272856 Issued in VA

Practice address

605 Emancipation Hwy
Fredericksburg, VA 22401-8403

Phone

(540) 310-0117

Fax

(540) 310-4736

NPI assigned

Oct 27, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA, WA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nsurenderanath6614@direct.erlanger.org
• Direct secure messaging: nsurenderanath824402@direct.multicare.org

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.

• Uva Community Health Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Charlottesville, VA
  • NPI 1598475741

  Single Specialty

  Medicare reassignment NPD
• Multicare Health System

  dba Multicare Neurological Surgery

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638

  Single Specialty

  Medicare reassignment NPD
• Multicare Health System

  dba MultiCare Deaconess Retail Pharmacy

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Multicare Health System

  dba Mary Bridge Child Abuse Intervention Dept

  • Pediatrics Physician
  • Tacoma, WA
  • NPI 1932152287
  NPD
• Children's Heart Institute

  dba Children's Heart Clinic

  • Specialist
  • Herndon, VA
  • NPI 1922058668

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1003992686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 EMANCIPATION HWY STE 101",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224018403",
            "telephone_number": "423-463-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 EMANCIPATION HWY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224018403",
            "telephone_number": "540-310-0117",
            "fax_number": "540-310-4736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12604 Lake Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Woodbridge",
            "state": "VA",
            "postal_code": "221922335",
            "country_code": "US",
            "telephone_number": "540-310-0117",
            "fax_number": "540-310-4736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SURENDERANATH",
        "first_name": "NISHA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "TN",
            "license": "42283",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "VA",
            "license": "0101272856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3000900",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Summers
• Margo B Sunday, LCSW
• Joshua K Sung, PA-C
• Sunny Home Care Inc.
• Sunshine Souls Counseling
• Surgical Associates of Fredericksburg LLC
• Surgical Associates of Fredericksburg, a Division of Maha, Inc.
• Surgical Associates of Fredericksburg, LTD.
• Surgical Physicians of Fredericksburg, PLLC
• Mitchell Surkamp, OD

• Pediatric Cardiology Physician in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Pediatric Cardiology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.