Individual provider Active NPI

Manjari Aravamuthan, M.D

  • Internal Medicine Physician
  • San Jose, CA
National Provider Identifier
1154410322
Registry record updated Aug 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
00A620782 Issued in CA
Practice address
200 Jose Figueres Ave
230
San Jose, CA 95116-1500
Phone
(408) 929-6922
Fax
(408) 929-8671
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 00A620782 CA Primary

Addresses

Primary practice location

200 Jose Figueres Ave
230
San Jose, CA 95116-1500

Mailing address

200 Jose Figueres Ave
230
San Jose, CA 95116-1500
Phone (408) 929-6922

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
I20080812000536 CA Practitioner - Internal Medicine 9830264761 Reassigns benefits to 1 organization
Practice locations: San Jose, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1569 Lexann Ave
Suite 220
San Jose, CA 95121-1795
Phone (408) 929-6922

Hospital & facility affiliations

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00A620782CAMDInternal Medicine Physician

Practice roles (4 of 5)

OrganizationSpecialtyStatusNew patients
Manjari Aravamuthan MD PC Internal Medicine CurrentSince Feb 19, 2018 Accepting new patients
County of Santa Clara Past Accepting new patients
El Camino Health Medical Network, LLC Past Accepting new patients
El Camino Hospital Past Accepting new patients

Locations

200 Jose Figueres Ave
Ste 230
San Jose, CA 95116
Phone (408) 929-6922

1569 Lexann Ave
Ste 220
San Jose, CA 95121
Phone (408) 504-2322

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: maravamuthan231580@santaclaravalley.direct-ci.net

Organizations & group practices 4

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.

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314230400000",
    "number": "1154410322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 JOSE FIGUERES AVE",
            "address_2": "230",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161500",
            "telephone_number": "408-929-6922",
            "fax_number": "408-929-8671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 JOSE FIGUERES AVE",
            "address_2": "230",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161500",
            "telephone_number": "408-929-6922",
            "fax_number": "408-929-8671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARAVAMUTHAN",
        "first_name": "MANJARI",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2011-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "00A620782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.