Individual provider Active NPI

Stella Edet Asuquo, M.D.

  • Vascular Surgery Physician
  • Fremont, CA
National Provider Identifier
1437460177
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
A156838 Issued in CA
Practice address
39141 Civic Center Dr Ste 335
Fremont, CA 94538-5878
Phone
(510) 248-1420
Fax
(510) 791-2874
NPI assigned
Jun 28, 2010
Last updated
Aug 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X A156838 CA Primary

Addresses

Primary practice location

39141 Civic Center Dr Ste 335
Fremont, CA 94538-5878

Mailing address

2500 Mowry Ave Ste 255
Fremont, CA 94538-1605
Phone (510) 248-1000

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
I20180814004174 CA Practitioner - Vascular Surgery 2365717220 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Indiana University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

39141 Civic Ctr Dr
Suite 335
Fremont, CA 94538-5878
Phone (510) 248-1400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)1-10
Varicose vein removal1-10
Leg revascularization (restoring blood flow)1-10
Removal of tissue21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A156838CAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Svmhs Clinics CurrentSince Aug 1, 2018 Accepting new patients
Washington Township Medical Foundation Vascular Surgery CurrentSince Aug 29, 2022 Accepting new patients
Svmhs Clinics CurrentSince Aug 1, 2018 Accepting new patients
Washington Township Medical Foundation CurrentSince Aug 29, 2022 Accepting new patients
Lancelot O Alexander MD a Medical Corporation Past Accepting new patients
Washington Township Medical Group Past Accepting new patients

Locations

2500 Mowry Ave
Ste 255
Fremont, CA 94538

39141 Civic Center Dr
Ste 335
Fremont, CA 94538
Phone (510) 248-1400

39500 Fremont Blvd
Ste 100
Fremont, CA 94538
Phone (510) 248-1800

1033 Los Palos Dr
Salinas, CA 93901
Phone (831) 424-2866

236 San Jose St
Salinas, CA 93901
Phone (831) 422-2666

Interoperability endpoints

  • Direct secure messaging: sasuquo142931@direct.whhs.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1437460177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 MOWRY AVE STE 255",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381605",
            "telephone_number": "510-248-1000",
            "fax_number": "510-608-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39141 CIVIC CENTER DR STE 335",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945385878",
            "telephone_number": "510-248-1420",
            "fax_number": "510-791-2874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASUQUO",
        "first_name": "STELLA",
        "middle_name": "EDET",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-28",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "A156838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.