Individual provider Active NPI

Krithika Chandrasekaran

  • Family Medicine Physician
  • Truckee, CA
National Provider Identifier
1144804543
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
PG204985 Issued in OR
Practice address
10121 Pine Ave
Truckee, CA 96161-4856
Phone
(530) 587-6011
NPI assigned
May 11, 2021
Last updated
Aug 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X PG204985 OR Primary

Addresses

Primary practice location

10121 Pine Ave
Truckee, CA 96161-4856

Mailing address

150 NE Kenneth Ford Dr
Roseburg, OR 97470-1042
Phone (541) 672-9596

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
I20240926003348 CA Practitioner - Family Practice 5395146229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tahoe Forest Hospital DistrictGroup PAC ID 0446161335, 140 clinicians

Practice addresses (Care Compare)

10051 Lake Ave
Suite 3
Truckee, CA 96161-4870
Phone (530) 587-7461

10121 Pine Ave
Truckee, CA 96161-4835
Phone (530) 587-6011

10121 Pine Ave
Truckee, CA 96161-4856

10175 Levone Ave
Truckee, CA 96161-4821
Phone (530) 582-3277

10800 Donner Pass Rd
A 103
Truckee, CA 96161-0432
Phone (530) 582-3440

10833 Donner Pass Rd
Suite 201
Truckee, CA 96161-4851
Phone (530) 582-3505

10956 Donner Pass Rd
Truckee, CA 96161-4860

12313 Soaring Way
Suite 1C and 2B
Truckee, CA 96161-3353
Phone (530) 582-6205

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tahoe Forest Hospital District CurrentSince Sep 1, 2024 Accepting new patients
Tahoe Forest Hospital District CurrentSince Sep 1, 2024 Accepting new patients

Locations

10051 Lake Ave
Ste 3
Truckee, CA 96161
Phone (530) 587-7461

10121 Pine Ave
Truckee, CA 96161
Phone (530) 582-3220

10956 Donner Pass Rd
Fl 23
Truckee, CA 96161
Phone (530) 587-3523

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1144804543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 NE KENNETH FORD DR",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974701042",
            "telephone_number": "541-672-9596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10121 PINE AVE",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961614856",
            "telephone_number": "530-587-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDRASEKARAN",
        "first_name": "KRITHIKA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-11",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "PG204985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Truckee, CA

Sources for this page

Verify at the official NPI Registry.