Organization Active NPI

Suresh R. Nayak MD., Inc.

  • Clinic/Center
  • San Jose, CA
National Provider Identifier
1629242086
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
A33868 Issued in CA
Legal business name
SURESH R. NAYAK MD., INC.
Practice address
200 Jose Figueres Ave
305
San Jose, CA 95116-1500
Phone
(408) 279-3692
NPI assigned
Apr 16, 2008
Organization subpart
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

Authorized official

Name
Suresh R Nayak, MDNPI 1871554147
Title
President
Phone
(408) 279-3692

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
Clinic/Center 261Q00000X A33868 CA Primary

Addresses

Primary practice location

200 Jose Figueres Ave
305
San Jose, CA 95116-1500

Mailing address

200 Jose Figueres Ave
305
San Jose, CA 95116-1500
Phone (408) 279-3692

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080429000445 CA Part B Supplier - Clinic/Group Practice 5890873061 Receives reassigned benefits from 1 practitioner
Practice locations: San Jose, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0607178Suresh R Nayak MD, Inc200 Jose Figueres Ave #305, San Jose, CA 95116Provider-performed microscopyJul 29, 2028

National Provider Directory

National Provider Directory

Locations

200 Jose Figueres Ave
Ste 305
San Jose, CA 95116
Phone (408) 279-3692

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208304000000",
    "number": "1629242086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 JOSE FIGUERES AVE",
            "address_2": "305",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161500",
            "telephone_number": "408-279-3692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 JOSE FIGUERES AVE",
            "address_2": "305",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161500",
            "telephone_number": "408-279-3692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURESH R. NAYAK MD., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-16",
        "last_updated": "2008-04-16",
        "status": "A",
        "authorized_official_last_name": "NAYAK",
        "authorized_official_first_name": "SURESH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-279-3692",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "A33868",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.