Individual provider Active NPI

Srividya Narasimhan Sampath, MD

  • Pediatrics Physician
  • San Diego, CA
National Provider Identifier
1275892754
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A132576 Issued in CA
Practice address
4725 Market St
San Diego, CA 92102-4715
Phone
(619) 515-2560
NPI assigned
May 3, 2012
Last updated
Aug 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A132576 CA Primary

Addresses

Primary practice location

4725 Market St
San Diego, CA 92102-4715

Mailing address

823 Gateway Center Way
San Diego, CA 92102

Other practice location 1

8788 Jamacha Rd
Spring Valley, CA 91977-4035
Phone (619) 515-2555

Other names 1

  • Srividya Narasimhan Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190417001586 CA Practitioner - Pediatric Medicine 2567703663 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A132576CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc CurrentSince Feb 20, 2019 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Scripps Health Current Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Family Health Centers of San Diego, Inc. CurrentSince Feb 20, 2019 Accepting new patients

Locations

4725 Market St
San Diego, CA 92102
Phone (619) 515-2560

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

8788 Jamacha Rd
Spring Valley, CA 91977
Phone (619) 515-2380

Interoperability endpoints

  • Direct secure messaging: ssampath80478@scrippshlth.medalliesdirect.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1275892754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 MARKET ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024715",
            "telephone_number": "619-515-2560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8788 Jamacha Rd",
            "address_purpose": "LOCATION",
            "city": "Spring Valley",
            "state": "CA",
            "postal_code": "919774035",
            "country_code": "US",
            "telephone_number": "619-515-2555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMPATH",
        "first_name": "SRIVIDYA",
        "middle_name": "NARASIMHAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-03",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A132576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SRIVIDYA",
            "last_name": "NARASIMHAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.