Individual provider Active NPI

Sujatha Buddhe, MD

  • Pediatric Cardiology Physician
  • Palo Alto, CA
National Provider Identifier
1417222779
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
C188579 Issued in CA
Practice address
725 Welch Rd
Palo Alto, CA 94304-1601
Phone
(425) 753-8167
NPI assigned
Mar 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X C188579 CA
Pediatric Cardiology Physician 2080P0202X 4301094394 MI
Pediatric Cardiology Physician 2080P0202X C188579 CA Primary

Addresses

Primary practice location

725 Welch Rd
Palo Alto, CA 94304-1601

Mailing address

725 Welch Rd
Palo Alto, CA 94304-1601
Phone (650) 497-8000

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
I20230830002288 CA Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 9739332537 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
LPCH Medical Group Div of LucileGroup PAC ID 0840298543, 332 clinicians

Practice addresses (Care Compare)

725 Welch Rd
Palo Alto, CA 94304-1601
Phone (650) 498-7200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C188579CAMDPediatrics Physician
4301094394MIMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stanford Health Care Pediatrics CurrentSince Aug 8, 2023 Accepting new patients
Stanford Health Care CurrentSince Aug 8, 2023 Accepting new patients
LPCH Medical Group Div of Lucile Pediatrics CurrentSince Aug 8, 2023 Accepting new patients
Stanford Health Care Pediatrics Current Accepting new patients
Lucile Salter Packard Children's Hospital at Stanford Past Accepting new patients
Seattle Children's Hospital Past Accepting new patients
Yakima Valley Memorial Hospital Association Past Accepting new patients
Harborview Meical Center Past Accepting new patients
University of Washington Past Accepting new patients
Virginia Mason Medical Center Past Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
Community Medical Center Inc Past Accepting new patients

Locations

725 Welch Rd
#D
Palo Alto, CA 94304

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/ef853cc1-94e4-4ed7-883a-9be7485e458e/

Organizations & group practices 12

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": "1332115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1417222779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-497-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "425-753-8167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUDDHE",
        "first_name": "SUJATHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-19",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C188579",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MI",
            "license": "4301094394",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "C188579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.