Lydia Dharshini Suryakumar, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A166986 Issued in CA

Practice address

1200 N Ventura Rd Ste E
Oxnard, CA 93030-3827

Phone

(805) 988-0053

Fax

(805) 988-0554

NPI assigned

May 3, 2017

Reactivated

Dec 12, 2017

Last updated

Jun 16, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Suryakumar Dharshini Lydia Other name

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

Specialty

Family Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clinicas del Camino Real IncGroup PAC ID 3173434396, 99 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Assisted Home Care Home health agency, Ventura, CA, CCN 058039

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lsuryakumar802689@direct.ochin.org
• Direct secure messaging: lydia.suryakumar.p1@direct.clinicas.nextgenshare.com

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.

• Clinicas del Camino Real Inc

  dba Clinicas del Camino Real, Inc., Ventura

  • Federally Qualified Health Center (FQHC)
  • Ventura, CA
  • NPI 1679631907
  Medicare reassignment Care Compare group NPD
• Clinicas del Camino Real Inc

  dba Clinicas del Camino Real Inc Roberto S Juarez

  • Community Health Clinic/Center
  • Oxnard, CA
  • NPI 1235866138
  NPD
• Clinicas del Camino Real Inc

  dba Clinicas del Camino Real, Inc., Karen R Burnham

  • Federally Qualified Health Center (FQHC)
  • Oxnard, CA
  • NPI 1093933194
  NPD (past)
• Clinicas del Camino Real Inc

  dba Clinicas del Camino Real, Inc., Paseo Camarillo

  • Federally Qualified Health Center (FQHC)
  • Camarillo, CA
  • NPI 1295297190
  NPD (past)
• Clinicas del Camino Real Inc

  dba Clinicas del Camino Real, Inc., La Colonia

  • Federally Qualified Health Center (FQHC)
  • Oxnard, CA
  • NPI 1942789359
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Assisted Home Recovery, Inc.

  dba Assisted Home Care

  • Home Health Agency
  • Ventura, CA
  • NPI 1619929734
  Care Compare affiliation

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1225564750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 FLYNN RD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125092",
            "telephone_number": "805-673-3930",
            "fax_number": "805-659-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N VENTURA RD STE E",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930303827",
            "telephone_number": "805-988-0053",
            "fax_number": "805-988-0554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURYAKUMAR",
        "first_name": "LYDIA",
        "middle_name": "DHARSHINI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-03",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "deactivation_date": "2017-12-06",
        "reactivation_date": "2017-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A166986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SURYAKUMAR",
            "last_name": "LYDIA",
            "middle_name": "DHARSHINI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kristine Supple, PA
• Supreme Care Hospice Inc
• Anagha Suresh, M.D.
• Gurrehma Suri
• Snyrrah Surjanto
• Susan Pembroke
• Courtney Farrell Swanson, LCSW
• Kaj Swanson, LCSW
• Kent A. Swanson, M.D.
• Estella Sweeney

• Family Medicine Physician in Oxnard, CA
• Providers in Oxnard, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.

Verify at the official NPI Registry.