Prodigy Psychiatric Group

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

PRODIGY PSYCHIATRIC GROUP

Practice address

5791 Capilano Dr
San Jose, CA 95138-2364

Phone

(408) 630-1209

NPI assigned

Jun 8, 2019

Organization subpart

No

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

Authorized official

Name

Beeta R Verma, MDNPI 1124397708

Title

President

Phone

(510) 875-7721

Specialties & licenses 2

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Beeta Verma, M.D.

  • Psychiatry Physician
  • San Jose, CA
  • NPI 1124397708
  NPD Authorized official

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

{
    "created_epoch": "1559952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1255990768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5791 CAPILANO DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951382364",
            "telephone_number": "510-875-7721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5791 CAPILANO DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951382364",
            "telephone_number": "408-630-1209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODIGY PSYCHIATRIC GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-08",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A",
        "authorized_official_last_name": "VERMA",
        "authorized_official_first_name": "BEETA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-875-7721",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "beeta.verma@prodigyclinic.com",
            "affiliation": "N",
            "address_1": "5791 Capilano Dr",
            "city": "San Jose",
            "state": "CA",
            "country_code": "US",
            "postal_code": "951382364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Psychiatry Physician in San Jose, CA
• Providers in San Jose, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.