Individual provider Active NPI

Prithvi Mruthyunjaya, MD

  • Retina Specialist (Ophthalmology) Physician
  • Stanford, CA
National Provider Identifier
1073670477
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
C144368 Issued in CA
Practice address
300 Pasteur Dr
Stanford, CA 94305-2200
Phone
(650) 723-4000
NPI assigned
Jan 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 200000279 NC
Ophthalmology Physician 207W00000X C144368 CA
Retina Specialist (Ophthalmology) Physician 207WX0107X C144368 CA Primary

Addresses

Primary practice location

300 Pasteur Dr
Stanford, CA 94305-2200

Mailing address

1804 Embarcadero Rd
Suite 100
Palo Alto, CA 94303-3341

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
I20161213002047 CA Practitioner - OphthalmologyPractitioner - Other (Physician) 9931137924 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stanford Health CareGroup PAC ID 6709797491, 3,152 clinicians
County of Santa ClaraGroup PAC ID 1254244973, shared by 46 NPIs, 1,000 clinicians

Practice addresses (Care Compare)

2452 Watson CT
Palo Alto, CA 94303-3216
Phone (650) 723-6995

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

751 S Bascom Ave
San Jose, CA 95128-2604
Phone (408) 885-5000

Hospital & facility affiliations

  • Stanford Health Care Hospital, Stanford, CA, CCN 050441

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200000279NCMDOphthalmology Physician
C144368CAMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Jan 5, 2019 Accepting new patients
County of Santa Clara CurrentSince Jan 5, 2019 Accepting new patients
County of Santa Clara Current Accepting new patients
Stanford Health Care CurrentSince Dec 1, 2016 Accepting new patients
County of Santa Clara Current Accepting new patients
University Healthcare Alliance Ophthalmology CurrentSince Mar 2, 2020 Accepting new patients
County of Santa Clara Ophthalmology CurrentSince Jan 5, 2019 Accepting new patients
Stanford Health Care CurrentSince Dec 1, 2016 Accepting new patients
County of Santa Clara CurrentSince Jan 5, 2019 Accepting new patients
Mark H Nelson MD PA Ophthalmology PastSince Sep 1, 1995 Accepting new patients
Duke University Health System, Inc. Past Accepting new patients
Affinity Medical Group Past Accepting new patients
Lucile Salter Packard Children'S Hospital at Stanford Past Accepting new patients
County of Santa Clara Past Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients

Locations

50 E Hamilton Ave
Ste 280
Campbell, CA 95008
Phone (408) 227-2646

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

27212 Calaroga Ave
Hayward, CA 94545
Phone (510) 783-5532

911 Sunset Dr
Hollister, CA 95023
Phone (831) 626-2640

15425 Los Gatos Blvd
Ste 120
Los Gatos, CA 95032
Phone (408) 340-5700

1300 Crane St
Menlo Park, CA 94025
Phone (510) 785-5000

7999 Gateway Blvd
Ste 200
Newark, CA 94560
Phone (510) 806-2947

2452 Watson Ct
Palo Alto, CA 94303
Phone (650) 721-6888

2452 Watson Ct
Ste 1700
Palo Alto, CA 94303
Phone (650) 723-5281

4725 1st St
Ste 100
Pleasanton, CA 94566
Phone (925) 462-7060

751 S Bascom Ave
Bldg Q
San Jose, CA 95128
Phone (408) 885-6770

1996 Lundy Ave
San Jose, CA 95131
Phone (408) 299-5846

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

751 S Bascom Ave
Fl 3
San Jose, CA 95128
Phone (408) 358-2511

2101 Alexian Dr
San Jose, CA 95116
Phone (408) 272-6050

751 S Bascom Ave
Ste 310
San Jose, CA 95128
Phone (408) 885-7924

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366

Interoperability endpoints

  • Direct secure messaging: pmruthyunjaya168438@direct.stanfordhealthcare.org
  • Direct secure messaging: pmruthyunjaya86314@santaclaravalley.direct-ci.net

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 7

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1073670477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 EMBARCADERO RD",
            "address_2": "SUITE 100",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943033341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MRUTHYUNJAYA",
        "first_name": "PRITHVI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "200000279",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "C144368",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "CA",
            "license": "C144368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.