Individual provider Active NPI

Laxmi Acharya Suthar

  • Internal Medicine Physician
  • Covina, CA
National Provider Identifier
1063459204
Registry record updated Dec 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A87432 Issued in CA
Practice address
1433 N Hollenbeck Ave
Suite 200
Covina, CA 91722-1558
Phone
(626) 331-2209
NPI assigned
May 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A87432 CA Primary

Addresses

Primary practice location

1433 N Hollenbeck Ave
Suite 200
Covina, CA 91722-1558

Mailing address

1433 N Hollenbeck Ave
Suite 200
Covina, CA 91722-1558
Phone (626) 331-2209

Other identifiers 7

IdentifierTypeStateIssuer
00A874320MedicaidCA
W11675OtherCAGROUP MEDICARE PIN
00A874320OtherCABLUE SHIELD
1356390009OtherCAGROUP NPI
990005307OtherCARAILROAD MEDICARE
CE1617OtherCAGROUP RAILROAD MEDICARE
GR0016910OtherCAGROUP MEDICAID PIN

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
I20060825000403 CA Practitioner - Internal Medicine 4587668983 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles Current Accepting new patients
County of Los Angeles Auditor Controller CurrentSince Aug 1, 2015 Accepting new patients
County of Los Angeles CurrentSince Aug 1, 2015 Accepting new patients
Usc Internal Medicine, Inc. Internal Medicine Past Accepting new patients
Mayflower Medical Group, Inc. Internal Medicine Past Accepting new patients

Locations

14445 Olive View Dr
#2C155
Sylmar, CA 91342
Phone (818) 364-3001

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

Organizations & group practices 5

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1063459204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1433 N HOLLENBECK AVE",
            "address_2": "SUITE 200",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917221558",
            "telephone_number": "626-331-2209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1433 N HOLLENBECK AVE",
            "address_2": "SUITE 200",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917221558",
            "telephone_number": "626-331-2209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTHAR",
        "first_name": "LAXMI",
        "middle_name": "ACHARYA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A87432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A874320",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PIN",
            "identifier": "W11675",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A874320",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1356390009",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "990005307",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP RAILROAD MEDICARE",
            "identifier": "CE1617",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID PIN",
            "identifier": "GR0016910",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

Verify at the official NPI Registry.