Kruthika Proddatoori, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A153221 Issued in CA

Practice address

13851 E 14TH St Ste 305
San Leandro, CA 94578-2630

Phone

(510) 351-1193

NPI assigned

Jun 25, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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

Internal Medicine

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Epic CareGroup PAC ID 5890053094, 54 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• BLC Homehealth Inc Home health agency, San Leandro, CA, CCN 053137
• Aspire Home Health Home health agency, Hayward, CA, CCN 559029
• Golden Pacific Home Health, Inc Home health agency, Alameda, CA, CCN 059441
• Crossroads Home Health & Hospice Home health agency, San Francisco, CA, CCN 557796
• Healthflex Home Health Services Home health agency, Oakland, CA, CCN 059551
• Eden Medical Center Hospital, Castro Valley, CA, CCN 050488
• Alta Bates Summit Medical Center Hospital, Oakland, CA, CCN 050043
• Alta Bates Summit Medical Center - Alta Bates Camp Hospital, Berkeley, CA, CCN 050305

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kproddatoori120867@ehr.johnmuirhealth.com

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.

• Epic Care

  • Multi-Specialty Clinic/Center
  • Antioch, CA
  • NPI 1780107797

  CA

  Medicare reassignment Care Compare group NPD

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

• Advanta Care Home Health Services, Inc.

  • Home Health Agency
  • Hayward, CA
  • NPI 1689172223
  Care Compare affiliation
• BLC Homehealth Inc.

  • Home Health Agency
  • San Leandro, CA
  • NPI 1295365658
  Care Compare affiliation
• Golden Pacific Home Health, Inc.

  • Home Health Agency
  • Alameda, CA
  • NPI 1104111483
  Care Compare affiliation
• Healthflex Home Health Services

  • Home Health Agency
  • Oakland, CA
  • NPI 1326399296
  Care Compare affiliation
• Owen Healthcare, LLC

  • Home Health Agency
  • San Francisco, CA
  • NPI 1205988854
  Care Compare affiliation
• Sutter Bay Hospitals

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

  Hospital

  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Oakland, CA
  • NPI 1295181477

  Hospital

  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Berkeley, CA
  • NPI 1639523004

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1679955694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 COUNTRY HILLS DR",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945097319",
            "telephone_number": "925-418-0282",
            "fax_number": "925-978-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13851 E 14TH ST STE 305",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945782630",
            "telephone_number": "510-351-1193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRODDATOORI",
        "first_name": "KRUTHIKA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-25",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A153221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Nancy Prince
• Mary Prince, DPM
• Allison E Prine
• Andrew Prine
• Sierra Prine
• Elias Protopsaltis, MFT
• Chiffon Pruitt
• Brigetta Scherr Pryor
• Pudding Pudding LLC
• Kathleen Erin Purdy

• All providers in San Leandro, CA
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; 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.