Individual provider Active NPI

Jayasree Padma Sundaram

  • Internal Medicine Physician
  • San Francisco, CA
National Provider Identifier
1417489840
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A160035 Issued in CA
Practice address
1101 Van Ness Ave
San Francisco, CA 94109-6919
Phone
(415) 600-6000
Fax
(415) 213-4659
NPI assigned
Apr 3, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A160035 CA Primary

Addresses

Primary practice location

1101 Van Ness Ave
San Francisco, CA 94109-6919

Mailing address

1101 Van Ness Ave
San Francisco, CA 94109-6919
Phone (415) 600-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200729002186 CA Practitioner - Internal Medicine 7517382294 Reassigns benefits to 1 organization
I20250818003153 GA Practitioner - Hospitalist 7517382294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of California, San Diego School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Inpatient Medical GroupGroup PAC ID 6608956966, 128 clinicians
Emory Medical Care Foundation IncGroup PAC ID 4981501814, 1,003 clinicians

Practice addresses (Care Compare)

1101 Van Ness Ave
San Francisco, CA 94109-6919
Phone (415) 485-8824

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone (404) 616-1000

Hospital & facility affiliations

  • Grady Memorial Hospital Hospital, Atlanta, GA, CCN 110079
  • California Pacific Medical Center - Mission Bernal Hospital, San Francisco, CA, CCN 050055

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
90
Promoting interoperability
100
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A160035CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc CurrentSince Aug 5, 2025 Accepting new patients
Pacific Inpatient Medical Group Internal Medicine CurrentSince Apr 1, 2023 Accepting new patients
Emory Medical Care Foundation Inc Internal Medicine CurrentSince Aug 5, 2025 Accepting new patients
Grady Memorial Hospital Corporation Past Accepting new patients

Locations

1101 Van Ness Ave
San Francisco, CA 94109
Phone (415) 485-8824

3555 Cesar Chavez
San Francisco, CA 94110
Phone (415) 485-8824

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

Interoperability endpoints

  • Direct secure messaging: jsundaram552482@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 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": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1417489840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 VAN NESS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941096919",
            "telephone_number": "415-600-6000",
            "fax_number": "415-213-4659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 VAN NESS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941096919",
            "telephone_number": "415-600-6000",
            "fax_number": "415-213-4659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDARAM",
        "first_name": "JAYASREE",
        "middle_name": "PADMA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A160035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.