NPIMap

Individual provider Active NPI

Niyatee Pradeep Samudra

  • Neurology Physician
  • Stanford, CA
National Provider Identifier
1710373360
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A170707 Issued in CA
Practice address
300 Pasteur Dr
Stanford, CA 94305-2200
Phone
(650) 723-4000
NPI assigned
Apr 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Epilepsy Physician 2084E0001X A170707 CA
Neurology Physician 2084N0400X A170707 CA Primary

Addresses

Primary practice location

300 Pasteur Dr
Stanford, CA 94305-2200

Mailing address

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210727001314 CA Practitioner - Neurology 5991108045 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Stanford Health CareGroup PAC ID 6709797491, 3,152 clinicians

Practice addresses (Care Compare)

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

Hospital & facility affiliations

  • Stanford Health Care Hospital, Stanford, CA, CCN 050441
  • Stanford Health Care Tri-Valley Hospital, Pleasanton, CA, CCN 050283

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
87.08
Promoting interoperability
100
Improvement activities
40
Cost
69.51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A170707CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Medical Group Business Services Neurology CurrentSince Jun 30, 2021 Accepting new patients
University of California San Francisco Neurology CurrentSince Jun 30, 2021 Accepting new patients
Stanford Health Care CurrentSince Jul 1, 2023 Accepting new patients
University of California San Francisco CurrentSince Jun 30, 2021 Accepting new patients
University of California San Francisco Current Accepting new patients
LPCH Medical Group Div of Lucile CurrentSince Jul 1, 2023 Accepting new patients
Stanford Health Care Neurology CurrentSince Jul 1, 2023 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jun 30, 2021 Accepting new patients
University of California San Francisco Past Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
Stanford Health Care Tri-Valley Past Accepting new patients
Lucile Salter Packard Children'S Hospital at Stanford Past Accepting new patients

Locations

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

1500 Owens St
Ste 320
San Francisco, CA 94158
Phone (415) 353-2069

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Interoperability endpoints

  • Direct secure messaging: nsamudra425053@direct.stanfordhealthcare.org

Organizations & group practices 12

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1710373360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUDRA",
        "first_name": "NIYATEE",
        "middle_name": "PRADEEP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-10",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084E0001X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Epilepsy",
            "state": "CA",
            "license": "A170707",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A170707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.