Deepa Kannaditharayil, MBBS

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

A143758 Issued in CA

Practice address

600 Coffee Rd
Modesto, CA 95355-4201

Phone

(209) 550-4785

Fax

(209) 550-4888

NPI assigned

Nov 18, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Neurology

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Stanford Health Care Tri-Valley Hospital, Pleasanton, CA, CCN 050283
• San Ramon Regional Medical Center Hospital, San Ramon, CA, CCN 050689
• Eden Medical Center Hospital, Castro Valley, CA, CCN 050488

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dkannaditharayil460812@hisp.ehr.sutterhealth.org

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.

• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment Care Compare group NPD
• Sutter Valley Medical Foundation

  • Multi-Specialty Clinic/Center
  • Modesto, CA
  • NPI 1669846986

  Neurology

  Medicare reassignment NPD
• Sutter Bay Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD
• Sutter Valley Medical Foundation

  • Durable Medical Equipment & Medical Supplies
  • Tracy, CA
  • NPI 1720930712
  NPD
• Sutter East Bay Medical Foundation

  • Family Medicine Physician
  • Orinda, CA
  • NPI 1871538769

  Neurology

  NPD (past)
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Modesto, CA
  • NPI 1699129601
  NPD (past)
• New York Westchester SQ Med Ctr

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1851340608
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• San Ramon Regional Medical Center, LLC

  • General Acute Care Hospital
  • San Ramon, CA
  • NPI 1932131489
  Care Compare affiliation
• Stanford Health Care Tri-Valley

  • General Acute Care Hospital
  • Pleasanton, CA
  • NPI 1144389941
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Castro Valley, CA
  • NPI 1063812907
  Care Compare affiliation

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

{
    "created_epoch": "1258502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1649508318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554201",
            "telephone_number": "209-550-4785",
            "fax_number": "209-550-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANNADITHARAYIL",
        "first_name": "DEEPA",
        "name_prefix": "Mrs.",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-18",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A143758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gurbinder Singh Kang
• Jaskiranjit Kang
• Sumanpreet Kang, B.A
• Susie Kang, RNFA
• Yung-Ming Kang, DDS CAGS DSCD
• Flora Kanon
• Raman W Kanon, MD
• Kanwal Khanna, M.D., Inc.
• Aarti Kanwar, MD
• Peter Kao, FNP

• Neurology Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.