Individual provider Active NPI

Gita Surti

  • Family Medicine Physician
  • Pleasanton, CA
National Provider Identifier
1578625646
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C133662 Issued in CA
Practice address
4456 Black Ave Ste 100
Pleasanton, CA 94566-6147
Phone
(925) 462-8100
NPI assigned
Dec 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C133662 CA Primary

Addresses

Primary practice location

4456 Black Ave Ste 100
Pleasanton, CA 94566-6147

Mailing address

PO Box 742244
Los Angeles, CA 90074-2244

Other practice location 1

200 Sanatorium Road
Hagerdorn Psychiatric Hosp-Medical Staff Services
Glen Gardner, NJ 08826-3291
Phone (908) 537-2141

Other practice location 2

200 Sanatorium Road
Hagerdorn Psychiatric Hosp-Medical Staff Services
Glen Gardner, NJ 08826-3291
Phone (908) 537-2141

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
C133662CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ravinder Singh MD., Inc Family Medicine PastSince Oct 11, 2020 Accepting new patients
The Doctor Is in, PA Family Medicine PastSince Dec 12, 1990 Accepting new patients
Angelo del Priore DPM Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: gita.surti.1@15887.direct.athenahealth.com

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": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1578625646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742244",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900742244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4456 BLACK AVE STE 100",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945666147",
            "telephone_number": "925-462-8100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Sanatorium Road",
            "address_2": "Hagerdorn Psychiatric Hosp-Medical Staff Services",
            "address_purpose": "LOCATION",
            "city": "Glen Gardner",
            "state": "NJ",
            "postal_code": "088263291",
            "country_code": "US",
            "telephone_number": "908-537-2141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Sanatorium Road",
            "address_2": "Hagerdorn Psychiatric Hosp-Medical Staff Services",
            "address_purpose": "LOCATION",
            "city": "Glen Gardner",
            "state": "NJ",
            "postal_code": "088263291",
            "country_code": "US",
            "telephone_number": "908-537-2141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SURTI",
        "first_name": "GITA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C133662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.