Individual provider Active NPI

Saurabh Prakash, MD, PHD

  • Internal Medicine Physician
  • San Jose, CA
National Provider Identifier
1205060399
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Practice address
751 S Bascom Ave
San Jose, CA 95128-2604
Phone
(408) 885-5111
NPI assigned
May 5, 2009
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 CA Primary

Addresses

Primary practice location

751 S Bascom Ave
San Jose, CA 95128-2604

Mailing address

1170 Alderbrook LN
San Jose, CA 95129-2956
Phone (650) 387-3758

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)
Not enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1205060399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 ALDERBROOK LN",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951292956",
            "telephone_number": "650-387-3758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604",
            "telephone_number": "408-885-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRAKASH",
        "first_name": "SAURABH",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.