Individual provider Active NPI

Sukanya Pillai Venkatachalam, M.D.

  • Psychiatry Physician
  • Pleasanton, CA
National Provider Identifier
1083878078
Registry record updated May 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A112695 Issued in CA
Practice address
5924 Stoneridge Dr
Suite 210
Pleasanton, CA 94588-2887
Phone
(925) 944-1733
Fax
(925) 223-6625
NPI assigned
Jul 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 125053856 IL
Psychiatry Physician 2084P0800X A112695 CA Primary

Addresses

Primary practice location

5924 Stoneridge Dr
Suite 210
Pleasanton, CA 94588-2887

Mailing address

5924 Stoneridge Dr
Suite 210
Pleasanton, CA 94588-2887
Phone (925) 944-1733

Other names 1

  • Sukanya Pillai Venkatachalam Other name

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
I20111005000741 CA Practitioner - Psychiatry 4587836010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Comprehensive Psychiatric Services a Medical GroupGroup PAC ID 0244329969, 74 clinicians

Practice addresses (Care Compare)

3100 Oak Rd
Suite 270
Walnut Creek, CA 94597-2078
Phone (925) 944-9711

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
112695CAMDClinical Social Worker
A112695CAMDPsychiatry Physician
125053856ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Psychiatric Services, a Medical Group Psychiatry CurrentSince Dec 6, 2014 Accepting new patients
Mark David Levine, MD Burlingame PC Psychiatry Past Accepting new patients
Mark David Levine, MD, Psychiatry Associates, P.C. Psychiatry Past Accepting new patients

Locations

5924 Stoneridge Dr
Ste 210
Pleasanton, CA 94588
Phone (925) 223-6157

3100 Oak Rd
Ste 270
Walnut Creek, CA 94597
Phone (925) 944-9711

Organizations & group practices 3

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": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432166400000",
    "number": "1083878078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5924 STONERIDGE DR",
            "address_2": "SUITE 210",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945882887",
            "telephone_number": "925-944-1733",
            "fax_number": "925-223-6625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5924 STONERIDGE DR",
            "address_2": "SUITE 210",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945882887",
            "telephone_number": "925-944-1733",
            "fax_number": "925-223-6625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENKATACHALAM",
        "first_name": "SUKANYA PILLAI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-18",
        "last_updated": "2015-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "125053856",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A112695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUKANYA PILLAI",
            "last_name": "VENKATACHALAM",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.