Individual provider Active NPI

Vadim Kagramanov, MD

  • Sleep Medicine (Internal Medicine) Physician
  • Sunnyvale, CA
National Provider Identifier
1396792552
Registry record updated Dec 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
License
C52994 Issued in CA
Practice address
1309 S Mary Ave
Suite 200
Sunnyvale, CA 94087-3050
Phone
(408) 523-3460
NPI assigned
May 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 4301086798 MI
Sleep Medicine (Internal Medicine) Physician 207RS0012X C52994 CA Primary

Addresses

Primary practice location

1309 S Mary Ave
Suite 200
Sunnyvale, CA 94087-3050

Mailing address

2350 W El Camino Real
2ND Floor
Mountain View, CA 94040-6201

Other identifiers 1

IdentifierTypeStateIssuer
4773470MedicaidMI

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
I20090521000167 CA Practitioner - Sleep MedicinePractitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 9638147747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sleep MedicineAlso: Critical Care (Intensivists), Pulmonary Disease
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

123 S San Mateo Dr
San Mateo, CA 94401-3804
Phone (650) 343-4200

301 Industrial Rd
San Carlos, CA 94070-2603
Phone (415) 600-1000

3200 Kearney St
Fremont, CA 94538-2299
Phone (510) 490-1222

370 Distel Cir
Los Altos, CA 94022-1404
Phone (650) 254-5200

550 S Green Valley Rd
Watsonville, CA 95076-3053
Phone (831) 458-5865

795 El Camino Real
Palo Alto, CA 94301-2302
Phone (415) 600-1020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C52994CAMDSleep Medicine (Internal Medicine) Physician
4301086798MIMDSleep Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Feb 23, 2009 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Feb 23, 2009 Accepting new patients
El Camino Hospital Past Accepting new patients
Saint Mary'S Health Services Past Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients

Locations

20410 Town Center Ln
Ste F150
Cupertino, CA 95014
Phone (408) 523-3460

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

2350 W El Camino Real
Fl 2
Mountain View, CA 94040
Phone (650) 691-6174

795 El Camino Real
#1112
Palo Alto, CA 94301

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

301 Industrial Rd
San Carlos, CA 94070
Phone (650) 596-4000

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

1309 S Mary Ave
Ste 200
Sunnyvale, CA 94087
Phone (408) 523-3460

325 N Mathilda Ave
Sunnyvale, CA 94085
Phone (408) 733-4380

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: vkagramanov34014@hisp.ehr.sutterhealth.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323043200000",
    "number": "1396792552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 W EL CAMINO REAL",
            "address_2": "2ND FLOOR",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940406201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 S MARY AVE",
            "address_2": "SUITE 200",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940873050",
            "telephone_number": "408-523-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAGRAMANOV",
        "first_name": "VADIM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2011-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "MI",
            "license": "4301086798",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "CA",
            "license": "C52994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4773470",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, CA

Sources for this page

Verify at the official NPI Registry.