Individual provider Active NPI

Nayantara Deepthi Seneviratne, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Campbell, CA
National Provider Identifier
1457363830
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
A67095 Issued in CA
Practice address
50 E Hamilton Ave Ste 280
Campbell, CA 95008-0273
Phone
(408) 227-2646
NPI assigned
Aug 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X A67095 CA Primary

Addresses

Primary practice location

50 E Hamilton Ave Ste 280
Campbell, CA 95008-0273

Mailing address

50 E Hamilton Ave Ste 280
Campbell, CA 95008-0273
Phone (408) 227-2646

Other practice location 1

1 Shrader St
Suite 578
San Francisco, CA 94117-1016
Phone (415) 668-6767

Other practice location 2

3883 Airway Dr Ste 201
Santa Rosa, CA 95403-1671
Phone (707) 521-7735

Other practice location 3

PO Box 590065
San Francisco, CA 94159-0065
Phone (000) 000-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20260603003457 GA Practitioner - EndocrinologyPractitioner - Internal Medicine 4880769306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Emory University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Alabama Endocrinology, P.C.Group PAC ID 8224187729, 7 clinicians

Practice addresses (Care Compare)

1400 Bradley Lake Blvd
Columbus, GA 31904-3688
Phone (706) 256-2525

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A67095CAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marin Hospitalist Medical Group, Inc. PastSince May 20, 2005 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nayantara.seneviratne@4310864691204.direct.elationemr.com

Organizations & group practices 2

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1457363830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 E HAMILTON AVE STE 280",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950080273",
            "telephone_number": "408-227-2646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 E HAMILTON AVE STE 280",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950080273",
            "telephone_number": "408-227-2646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Shrader St",
            "address_2": "Suite 578",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941171016",
            "country_code": "US",
            "telephone_number": "415-668-6767",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3883 Airway Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954031671",
            "country_code": "US",
            "telephone_number": "707-521-7735",
            "fax_number": "707-573-5422",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "PO Box 590065",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941590065",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SENEVIRATNE",
        "first_name": "NAYANTARA",
        "middle_name": "DEEPTHI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A67095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

Verify at the official NPI Registry.