Individual provider Active NPI

Sureshni Surendranathan, PA-C

  • Surgical Physician Assistant
  • Norwalk, CT
National Provider Identifier
1306579156
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
6205 Issued in CT
Practice address
34 Maple St
Norwalk, CT 06850-3894
Phone
(203) 852-2000
NPI assigned
Jul 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 6205 CT Primary

Addresses

Primary practice location

34 Maple St
Norwalk, CT 06850-3894

Mailing address

326 N 2ND St Apt D
Alhambra, CA 91801-2331
Phone (626) 506-3594

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240205001833 CT Practitioner - Physician Assistant 6709229990
I20241015004122 CA Practitioner - Physician Assistant 6709229990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usc Care Medical Group IncGroup PAC ID 0446157747, 1,378 clinicians

Practice addresses (Care Compare)

1500 San Pablo St
Los Angeles, CA 90033-5313
Phone (323) 442-8444

1516 San Pablo St
Los Angeles, CA 90033-5313
Phone (800) 872-2273

1520 San Pablo St
Los Angeles, CA 90033-5310
Phone (800) 872-2273

1520 San Pablo St 1St Floor N
Los Angeles, CA 90033-5310
Phone (800) 872-2273

300 W Hungtington Dr
Arcadia, CA 91007-3402
Phone (626) 898-8000

Hospital & facility affiliations

  • Usc Arcadia Hospital Hospital, Arcadia, CA, CCN 050238
  • Keck Hospital of Usc Hospital, Los Angeles, CA, CCN 050696

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6205CTMDMental Health Counselor
64430CAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Sep 8, 2024 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Sep 8, 2024 Accepting new patients

Locations

1000 S Fremont Ave
Bldg A11
Alhambra, CA 91803
Phone (626) 457-4240

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1518 San Pablo St
Ste 3500
Los Angeles, CA 90033

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1306579156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 N 2ND ST APT D",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918012331",
            "telephone_number": "626-506-3594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 MAPLE ST",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068503894",
            "telephone_number": "203-852-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURENDRANATHAN",
        "first_name": "SURESHNI",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-07",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "6205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.