Individual provider Active NPI

Eswar Appa Nyamathi, MD

  • Vascular Surgery Physician
  • Northridge, CA
National Provider Identifier
1528050960
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
A40919 Issued in CA
Practice address
17075 Devonshire St
Ste 106
Northridge, CA 91325-1600
Phone
(818) 831-3287
Fax
(818) 831-3267
NPI assigned
Aug 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

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 A40919 CA Primary

Addresses

Primary practice location

17075 Devonshire St
Ste 106
Northridge, CA 91325-1600

Mailing address

17075 Devonshire St
Ste 106
Northridge, CA 91325-1600
Phone (818) 831-3287

Other identifiers 1

IdentifierTypeStateIssuer
00A409190MedicaidCA

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alan Shiener MD Inc. Past Accepting new patients
Simi San Fernando Valley Urology Associates Past Accepting new patients
Kami Woman'S Care Past Accepting new patients

Organizations & group practices 3

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": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208304000000",
    "number": "1528050960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST",
            "address_2": "STE 106",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913251600",
            "telephone_number": "818-831-3287",
            "fax_number": "818-831-3267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST",
            "address_2": "STE 106",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913251600",
            "telephone_number": "818-831-3287",
            "fax_number": "818-831-3267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYAMATHI",
        "first_name": "ESWAR",
        "middle_name": "APPA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2008-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "A40919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A409190",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; 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.