Individual provider Active NPI

Maya Nambisan, M.D.

  • Obstetrics & Gynecology Physician
  • Pleasanton, CA
National Provider Identifier
1396041042
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A111198 Issued in CA
Practice address
4725 1St St
Pleasanton, CA 94566-7366
Phone
(925) 734-3333
NPI assigned
Jan 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A111198 CA Primary

Addresses

Primary practice location

4725 1St St
Pleasanton, CA 94566-7366

Mailing address

4725 1St St
Pleasanton, CA 94566-7366
Phone (925) 734-3333

Other practice location 1

1191 E Yosemite Ave Ste C
Manteca, CA 95336-5071
Phone (209) 824-2202

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
I20141118001901 CA Practitioner - Obstetrics/Gynecology 8426270927 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Illinois Medical College, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Healthcare AllianceGroup PAC ID 6305748799, 334 clinicians

Practice addresses (Care Compare)

4725 1St St
Suite 100
Pleasanton, CA 94566-7366
Phone (925) 462-7060

Hospital & facility affiliations

  • Stanford Health Care Tri-Valley Hospital, Pleasanton, CA, CCN 050283

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A111198CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg California, P.C. Obstetrics & Gynecology CurrentSince Jul 2, 2023 Accepting new patients
University Healthcare Alliance Obstetrics & Gynecology CurrentSince Jul 30, 2024 Accepting new patients
Stanford Health Care Obstetrics & Gynecology Past Accepting new patients
Affinity Medical Group Past Accepting new patients

Locations

50 E Hamilton Ave
Ste 280
Campbell, CA 95008
Phone (408) 227-2646

815 Pollard Rd
Los Gatos, CA 95032
Phone (408) 378-6131

1300 Crane St
Menlo Park, CA 94025
Phone (510) 785-5000

2500 Grant Rd
Mountain View, CA 94040
Phone (650) 903-9500

4725 1st St
Ste 100
Pleasanton, CA 94566
Phone (925) 462-7060

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mnambisan162254@hisp.ehr.sutterhealth.org

Organizations & group practices 4

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 1

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": "1296086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1396041042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4725 1ST ST",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945667366",
            "telephone_number": "925-734-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 1ST ST",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945667366",
            "telephone_number": "925-734-3333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1191 E Yosemite Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Manteca",
            "state": "CA",
            "postal_code": "953365071",
            "country_code": "US",
            "telephone_number": "209-824-2202",
            "fax_number": "209-824-2205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAMBISAN",
        "first_name": "MAYA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-27",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A111198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.