Organization Active NPI

Keshav R. Nayak, MD, AMC

  • Cardiovascular Disease Physician
  • San Diego, CA
National Provider Identifier
1528559242
Registry record updated May 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A72112 Issued in CA
Legal business name
KESHAV R. NAYAK, MD, AMC
Practice address
501 Washington St Ste 512
San Diego, CA 92103-2238
Phone
(619) 297-0014
Fax
(619) 297-1014
NPI assigned
May 29, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2018

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

Authorized official

Name
Keshav R. Nayak, M.D.NPI 1043246531
Title
President
Phone
(619) 297-0014

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
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X A72112 CA Primary

Addresses

Primary practice location

501 Washington St Ste 512
San Diego, CA 92103-2238

Mailing address

501 Washington St Ste 512
San Diego, CA 92103-2238
Phone (619) 297-0014

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190212001708 CA Part B Supplier - Clinic/Group Practice 1951646330 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

230 Prospect Pl
#250
Coronado, CA 92118
Phone (619) 297-0014

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": "1527552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527552000000",
    "number": "1528559242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 WASHINGTON ST STE 512",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032238",
            "telephone_number": "619-297-0014",
            "fax_number": "619-297-1014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 WASHINGTON ST STE 512",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032238",
            "telephone_number": "619-297-0014",
            "fax_number": "619-297-1014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KESHAV R. NAYAK, MD, AMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-29",
        "last_updated": "2018-05-29",
        "status": "A",
        "authorized_official_last_name": "NAYAK",
        "authorized_official_first_name": "KESHAV",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-297-0014",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A72112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2018; 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.