Individual provider Active NPI

Swaminadhan Gnanashanmugam, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Saint Helena, CA
National Provider Identifier
1073765517
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
A171765 Issued in CA
Practice address
10 Woodland Rd
Saint Helena, CA 94574-9554
Phone
(650) 804-8093
NPI assigned
Oct 15, 2008
Last updated
Nov 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 036157660 IL
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X ME173914 FL
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X A171765 CA Primary

Addresses

Primary practice location

10 Woodland Rd
Saint Helena, CA 94574-9554

Mailing address

5082 Dupont Dr
Santa Rosa, CA 95409-3743
Phone (650) 804-8093

Other practice location 1

17360 Brookhurst Street
Fountain Valley, CA 92708-3720
Phone (714) 665-1797

Other practice location 2

1350 Hickory St
Melbourne, FL 32901-3224
Phone (321) 434-3455

Other identifiers 2

IdentifierTypeStateIssuer
128981100MedicaidFL
WF482OtherFLHFMG

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://memorialcare.org/fhir/api/FHIR/R4/ Health Information Exchange (HIE) MemorialCare Medical Foundation

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, CA, FL3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20211206002303 IL Practitioner - Thoracic SurgeryPractitioner - Cardiac Surgery 2668805912 Reassigns benefits to 1 organization
I20230801003299 CA Practitioner - Thoracic SurgeryPractitioner - Cardiac Surgery 2668805912 Reassigns benefits to 4 organizations
I20251031000843 FL Practitioner - Thoracic Surgery 2668805912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic SurgeryAlso: Cardiac Surgery
Education
Northwestern University Feinberg Medical School, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

401 I St
Marysville, CA 95901-5626
Phone (530) 743-5125

500 Doyle Park Dr
Suite G05
Santa Rosa, CA 95405-4555
Phone (707) 576-7100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)28
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A171765CAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
ME173914FLMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Sep 3, 2024 Accepting new patients
Adventist Health Physicians Network Current Accepting new patients
Health First Medical Group, LLC CurrentSince Dec 20, 2025 Accepting new patients
Adventist Health Physicians Network CurrentSince Sep 1, 2024 Accepting new patients
Memorialcare Medical Foundation CurrentSince Jul 15, 2023 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2022 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2022 Accepting new patients
Providence Medical Foundation CurrentSince Sep 3, 2024 Accepting new patients
Adventist Health Physicians Network CurrentSince Sep 1, 2024 Accepting new patients
St. Helena Hospital CurrentSince Sep 1, 2024 Accepting new patients
Health First Medical Group, LLC Surgery CurrentSince Dec 20, 2025 Accepting new patients
St. Helena Hospital CurrentSince Sep 1, 2024 Accepting new patients
Adventist Health Heart Institute-Ukiah Past Accepting new patients

Locations

913 Washington St
Calistoga, CA 94515
Phone (707) 942-0844

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

2888 Long Beach Blvd
Ste 165
Long Beach, CA 90806
Phone (562) 595-5380

401 I St
Marysville, CA 95901
Phone (530) 671-3526

10 Woodland Rd
Saint Helena, CA 94574
Phone (707) 261-7821

6 Woodland Rd
Ste 202
Saint Helena, CA 94574
Phone (707) 963-5294

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

500 Doyle Park Dr
Ste G05
Santa Rosa, CA 95405
Phone (707) 576-7100

699 W Cocoa Beach Cswy
Ste 405
Cocoa Beach, FL 32931
Phone (321) 868-7272

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

1350 Hickory St
Ste 102
Melbourne, FL 32901
Phone (321) 434-3455

Dept 5777
Carol Stream, IL 60122

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

25 N Winfield Rd
Ste 201
Winfield, IL 60190
Phone (630) 933-4480

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: sgnanashanmugam796448@direct.memorialcare.org

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 15

Hospital & facility affiliations 6

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": "1224028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1073765517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5082 DUPONT DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954093743",
            "telephone_number": "650-804-8093",
            "fax_number": "650-804-8093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WOODLAND RD",
            "city": "SAINT HELENA",
            "state": "CA",
            "postal_code": "945749554",
            "telephone_number": "650-804-8093"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17360 Brookhurst Street",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "927083720",
            "country_code": "US",
            "telephone_number": "714-665-1797",
            "fax_number": "714-665-4680",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 Hickory St",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329013224",
            "country_code": "US",
            "telephone_number": "321-434-3455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GNANASHANMUGAM",
        "first_name": "SWAMINADHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-15",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IL",
            "license": "036157660",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": "ME173914",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "A171765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128981100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HFMG",
            "identifier": "WF482",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://memorialcare.org/fhir/api/FHIR/R4/",
            "affiliation": "Y",
            "endpointDescription": "MemorialCare FHIR Endpoint",
            "affiliationName": "MemorialCare Medical Foundation",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "17360 Brookhurst St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927083720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Helena, CA

Sources for this page

Verify at the official NPI Registry.