Individual provider Active NPI

Bailey V Sudindra Vittal, MD

  • Gastroenterology Physician
  • San Jose, CA
National Provider Identifier
1477594604
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A25286 Issued in CA
Practice address
150 N Jackson Avenue
Suite 107
San Jose, CA 95116-1908
Phone
(408) 926-2182
Fax
(408) 926-8370
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A25286 CA Primary

Addresses

Primary practice location

150 N Jackson Avenue
Suite 107
San Jose, CA 95116-1908

Mailing address

150 N Jackson Avenue
Suite 107
San Jose, CA 95116-1908
Phone (408) 926-2182

Other identifiers 1

IdentifierTypeStateIssuer
00A252860MedicaidCA

Other names 1

  • Sudin Vittal Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A25286CAMDGastroenterology Physician

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1477594604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 N JACKSON AVENUE",
            "address_2": "SUITE 107",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161908",
            "telephone_number": "408-926-2182",
            "fax_number": "408-926-8370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N JACKSON AVENUE",
            "address_2": "SUITE 107",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161908",
            "telephone_number": "408-926-2182",
            "fax_number": "408-926-8370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITTAL",
        "first_name": "BAILEY V",
        "middle_name": "SUDINDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A25286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A252860",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUDIN",
            "last_name": "VITTAL",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.