Individual provider Active NPI

Vineela R Poddatoori, MD

  • Obstetrics & Gynecology Physician
  • San Jose, CA
National Provider Identifier
1205017589
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A97939 Issued in CA
Practice address
751 S Bascom Ave
OB GYN
San Jose, CA 95128-2604
Phone
(408) 885-5000
NPI assigned
Nov 15, 2007
Last updated
Jan 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A97939 CA Primary

Addresses

Primary practice location

751 S Bascom Ave
OB GYN
San Jose, CA 95128-2604

Mailing address

751 S Bascom Ave
OB GYN
San Jose, CA 95128-2604
Phone (408) 885-5000

Other practice location 1

3595 Mt Diablo Blvd Ste 350
Lafayette, CA 94549-3849
Phone (510) 204-5600

Other names 1

  • Miss Vineela Muni Ravva Former 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
I20091012000279 CA Practitioner - Obstetrics/Gynecology 5698811214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Ohio State University College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

2450 Ashby Ave
Berkeley, CA 94705-2067
Phone (510) 204-4444

3200 Kearney St
Fremont, CA 94538-2299
Phone (510) 490-1222

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A97939CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation Obstetrics & Gynecology CurrentSince Aug 1, 2017 Accepting new patients
Sutter Bay Medical Foundation Current Accepting new patients
Sutter Bay Medical Foundation CurrentSince Aug 1, 2017 Accepting new patients
Alta Bates Summit Medical Center Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients

Locations

2850 Telegraph Ave
Ste 120
Berkeley, CA 94705
Phone (510) 204-8140

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

3595 Mt Diablo Blvd
Ste 350
Lafayette, CA 94549
Phone (510) 204-2990

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

12 Camino Encinas
Orinda, CA 94563
Phone (510) 204-8180

Interoperability endpoints

  • Direct secure messaging: vpoddatoori43011@hisp.ehr.sutterhealth.org

Organizations & group practices 5

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 2

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": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1205017589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "address_2": "OB GYN",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604",
            "telephone_number": "408-885-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "address_2": "OB GYN",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604",
            "telephone_number": "408-885-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3595 Mt Diablo Blvd Ste 350",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "CA",
            "postal_code": "945493849",
            "country_code": "US",
            "telephone_number": "510-204-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PODDATOORI",
        "first_name": "VINEELA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-15",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A97939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VINEELA",
            "last_name": "RAVVA",
            "middle_name": "MUNI",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.