Individual provider Active NPI

Raman Nambisan, MD

  • Surgery Physician
  • Pleasanton, CA
National Provider Identifier
1154358992
Registry record updated Apr 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A37212 Issued in CA
Practice address
5575 W Las Positas Blvd
#270
Pleasanton, CA 94588
Phone
(925) 460-3883
Fax
(925) 460-3883
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A37212 CA Primary

Addresses

Primary practice location

5575 W Las Positas Blvd
#270
Pleasanton, CA 94588

Mailing address

5575 W Las Positas Blvd
#270
Pleasanton, CA 94588-5801
Phone (925) 460-3883

Other identifiers 1

IdentifierTypeStateIssuer
00A372120MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A37212CAMDSurgery Physician
37212CAMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335225600000",
    "number": "1154358992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5575 W LAS POSITAS BLVD",
            "address_2": "#270",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945885801",
            "telephone_number": "925-460-3883",
            "fax_number": "925-460-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5575 W LAS POSITAS BLVD",
            "address_2": "#270",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "94588",
            "telephone_number": "925-460-3883",
            "fax_number": "925-460-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAMBISAN",
        "first_name": "RAMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2012-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A37212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A372120",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.