Suchet Srivamsi Suryadevara Rao, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

C172363 Issued in CA

Practice address

1805 Medical Center Dr
San Bernardino, CA 92411-1217

Phone

(909) 887-6333

NPI assigned

Sep 3, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, CA2 enrollments

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 2

Specialty

Psychiatry

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Heritage Medical Group IncGroup PAC ID 7517284029, 62 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Hospital of San Bernardino Hospital, San Bernardino, CA, CCN 050089

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: srao681440@nychhc.direct-ci.com
• Direct secure messaging: suchet.rao.1@9865.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pacific Heritage Medical Group Inc

  • Geriatric Psychiatry Physician
  • Westlake Village, CA
  • NPI 1467899450
  Medicare reassignment Care Compare group NPD
• Asana Integrated Medical Group PC

  • Psychiatry Physician
  • Sioux Falls, SD
  • NPI 1396783379

  CA

  Medicare reassignment NPD
• DLP Western Carolina Physician Practices LLC

  • Internal Medicine Physician
  • Sylva, NC
  • NPI 1609281641
  Medicare reassignment NPD
• DLP Western Carolina Physician Practices LLC

  • Diagnostic Radiology Physician
  • Clyde, NC
  • NPI 1932925062
  NPD
• Hi-Desert Memorial Health Care District

  • Federally Qualified Health Center (FQHC)
  • Yucca Valley, CA
  • NPI 1649708611
  NPD (past)
• Precise Behavioral, Inc.

  • Psychiatry Physician
  • Westlake Village, CA
  • NPI 1043008675
  NPD (past)

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

• Community Hospital of San Bernardino

  • General Acute Care Hospital
  • San Bernardino, CA
  • NPI 1235290818
  Care Compare affiliation

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

{
    "created_epoch": "1283472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1275840878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 WAGON TRAIN LN",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917653651",
            "telephone_number": "520-275-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 MEDICAL CENTER DR",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924111217",
            "telephone_number": "909-887-6333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "432 W 52nd St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100197651",
            "country_code": "US",
            "telephone_number": "520-275-7767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAO",
        "first_name": "SUCHET",
        "middle_name": "SRIVAMSI SURYADEVARA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-03",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C172363",
            "primary": true
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "NY",
            "license": "280209",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "280209",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "280209",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justine Rangel
• Marlene Rangel
• Gianni Rankins
• Maricelle Ranola, RDN, MPH
• Philis Denise Ransom, M.D.
• Talia Rapel, MA
• Haley Rashidi
• Jessica Racine Rasmussen
• Serehnaty Rasmussen
• Rasouli Medical Group

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; 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.