Active NPI
Surekha Santoshkumar Vetsa, M.D
- Internal Medicine Physician
- Sunnyvale, CA
National Provider Identifier
1184650871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A90010
- Practice address
- 1351 Selo Dr
Sunnyvale, CA 94087-4411 - Phone
- (650) 888-1917
- Fax
- (408) 733-0777
- NPI assigned
- Jun 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | A90010 | CA | |
| Internal Medicine Physician | 207R00000X | A90010 | CA | Primary |
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | A90010 | CA |
Addresses
Primary practice location
1351 Selo Dr
Sunnyvale, CA 94087-4411
Mailing address
1351 Selo Dr
Sunnyvale, CA 94087-4411
Phone (650) 888-7556
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A900100 | Other | CA | BLUE SHIELD OF CALIFORNIA |
| 00A900100 | Medicaid | CA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050322000225 | CA | Practitioner - Internal Medicine | 3274588306 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
150 N Jackson Ave
Suite 105
San Jose, CA 95116-1908
Phone (408) 258-0900
Hospital & facility affiliations
- South Springs Home Health Care
- Palmeira Home Health
- Harmony Home Health
- Lorian Health
- Sequoia Home Health
- Santa Clara Valley Medical Center
- Good Samaritan Hospital
- El Camino Health
- Stanford Health Care
- Canyon Springs Post-Acute
- Vista Manor Nursing Center
- Mission de la Casa
- The Redwoods Post-Acute
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.45 of 100
- Quality
- 74.21
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A90010 | CA | MD | Emergency Medicine Physician |
Practice roles (2 of 3)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Surekha S Vetsa MD a Medical Corporation | Emergency Medicine | Current | Accepting new patients |
| El Camino Health Medical Network, LLC | Past | Accepting new patients |
Locations
815 Pollard Rd
Los Gatos, CA 95032
Phone (408) 378-6131
150 N Jackson Ave
Ste 105
San Jose, CA 95116
Phone (408) 258-0900
150 N Jackson Ave
Ste 105C
San Jose, CA 95116
Phone (650) 888-1917
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- svesta44731@santaclaravalley.direct-ci.net
Ownership & related parties
All facility ownership & control disclosures 2
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Mission de la Casa | Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Jun 1, 2020 Jun 1, 2020 |
| Canyon Springs Post-Acute | Skilled nursing facility | Contracted Managing Employee | Mar 1, 2018 |
Owned or controlled facilities with NPI records 2
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Skilled Nursing Facility
- San Jose, CA
- NPI 1720032329
Adp of the SNF, Operational/Managerial Control
-
- Skilled Nursing Facility
- San Jose, CA
- NPI 1639548308
Contracted Managing Employee
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- San Jose, CA
- NPI 1619043874
CA, Emergency Medicine
-
- Multi-Specialty Clinic/Center
- San Jose, CA
- NPI 1164880761
Hospital & facility affiliations 21
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- San Francisco, CA
- NPI 1417441361
-
- Home Health Agency
- San Jose, CA
- NPI 1215032123
-
- Home Health Agency
- San Jose, CA
- NPI 1538469929
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202428800000",
"number": "1184650871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1351 SELO DR",
"city": "SUNNYVALE",
"state": "CA",
"postal_code": "940874411",
"telephone_number": "650-888-7556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1351 SELO DR",
"city": "SUNNYVALE",
"state": "CA",
"postal_code": "940874411",
"telephone_number": "650-888-1917",
"fax_number": "408-733-0777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VETSA",
"first_name": "SUREKHA",
"middle_name": "SANTOSHKUMAR",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-24",
"last_updated": "2008-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "A90010",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A90010",
"primary": true
},
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "CA",
"license": "A90010",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF CALIFORNIA",
"identifier": "00A900100",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A900100",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sunnyvale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.