Srujan Ganta, MD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

A166273 Issued in CA

Practice address

3020 Childrens Way
San Diego, CA 92123-4223

Phone

(858) 966-8030

NPI assigned

Dec 26, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Regents of the University of California

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • San Diego, CA
  • NPI 1235232778
  Medicare reassignment NPD
• Rady Children's Hospital San Diego

  dba Rady Children's Specialists of San Diego, A Medical Foundation

  • Pediatrics Physician
  • San Diego, CA
  • NPI 1669617197
  Medicare reassignment
• Regents of the University of California

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1558463927
  NPD
• Marilyn Kaufhold, M.D., a Medical Corporation

  • Children's Hospital
  • San Diego, CA
  • NPI 1336359389
  NPD (past)

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

{
    "created_epoch": "1577318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1265071005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # MC5003",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-309-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-966-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANTA",
        "first_name": "SRUJAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-26",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "A166273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Addison Newkirk Gann
• Joseph Patrick Gannon, PH.D.
• Nicholas Edward Gannon, DO
• Seth Michael Gans, LMFT
• Ashley Marie Gant
• Allan Nelson Ganuza, IDC
• Susan E Ganz, PHD, ATC
• Andrew Ganzekaufer, PH.D.
• Gabbie Bustamante Ganzon
• Juvelyn Ganzon

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.