Organization Active NPI

South Bay Retina a Medical Corporation

  • Ophthalmology Physician
  • San Jose, CA
National Provider Identifier
1487684106
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G831730 Issued in CA
Legal business name
SOUTH BAY RETINA A MEDICAL CORPORATION
Practice address
455 Oconnor Dr Ste 310
San Jose, CA 95128-1644
Phone
(408) 294-3534
Fax
(408) 294-3214
NPI assigned
Jul 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Authorized official

Name
Keshav Narain, MDNPI 1487680328
Title
Director
Phone
(408) 294-3534

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X G831730 CA Primary

Addresses

Primary practice location

455 Oconnor Dr Ste 310
San Jose, CA 95128-1644

Mailing address

455 Oconnor Dr Ste 310
San Jose, CA 95128-1644
Phone (408) 294-3534

Other practice location 1

9360 N Name Uno Ste 210
Gilroy, CA 95020-3535
Phone (408) 294-3534

Other identifiers 1

IdentifierTypeStateIssuer
00G831730MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081002000378 CA Part B Supplier - Clinic/Group Practice 9739257858 Receives reassigned benefits from 1 practitioner
Practice locations: Gilroy, CA; San Jose, CA

National Provider Directory

National Provider Directory

Locations

9360 No Name Uno
Ste 210
Gilroy, CA 95020
Phone (408) 294-3534

333 W El Camino Real
Ste 340
Sunnyvale, CA 94087
Phone (408) 294-3534

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3604/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777334400000",
    "number": "1487684106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 OCONNOR DR STE 310",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281644",
            "telephone_number": "408-294-3534",
            "fax_number": "408-294-3214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 OCONNOR DR STE 310",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281644",
            "telephone_number": "408-294-3534",
            "fax_number": "408-294-3214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9360 N Name Uno Ste 210",
            "address_purpose": "LOCATION",
            "city": "Gilroy",
            "state": "CA",
            "postal_code": "950203535",
            "country_code": "US",
            "telephone_number": "408-294-3534",
            "fax_number": "408-294-3214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTH BAY RETINA A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A",
        "authorized_official_last_name": "NARAIN",
        "authorized_official_first_name": "KESHAV",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "408-294-3534",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G831730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G831730",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Apr 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.