Individual provider Active NPI

Dattanand Melukote Sudarshana, MD

  • Neurology Physician
  • Antioch, CA
National Provider Identifier
1710440656
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A177777 Issued in CA
Practice address
4053 Lone Tree Way Ste 100
Antioch, CA 94531-6210
Phone
(925) 776-7725
NPI assigned
Apr 8, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X A177777 CA Primary

Addresses

Primary practice location

4053 Lone Tree Way Ste 100
Antioch, CA 94531-6210

Mailing address

4053 Lone Tree Way Ste 100
Antioch, CA 94531-6210
Phone (925) 776-7725

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230929001419 CA Practitioner - Neurology 4385063015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of California, San Francisco School of Medicine, 2023
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)

2850 Telegraph Ave
Berkeley, CA 94705-1159

3200 Kearney St
Fremont, CA 94538-2299
Phone (510) 490-1222

3901 Lone Tree Way
Antioch, CA 94509-6200
Phone (650) 845-7649

795 El Camino Real
Palo Alto, CA 94301-2302
Phone (415) 600-1020

Hospital & facility affiliations

  • Sutter Delta Medical Center Hospital, Antioch, CA, CCN 050523
  • Alta Bates Summit Medical Center - Alta Bates Camp Hospital, Berkeley, CA, CCN 050305
  • Eden Medical Center Hospital, Castro Valley, CA, CCN 050488
  • Alta Bates Summit Medical Center Hospital, Oakland, CA, CCN 050043

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A177777CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Sep 5, 2023 Accepting new patients
Sutter Bay Medical Foundation Multi-Specialty CurrentSince Sep 5, 2023 Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients
Sutter East Bay Medical Foundation Multi-Specialty Past Accepting new patients

Locations

4053 Lone Tree Way
Ste 101
Antioch, CA 94531
Phone (925) 756-3400

4053 Lone Tree Way
Ste 100
Antioch, CA 94531
Phone (925) 756-3400

18400 US Highway 18
Apple Valley, CA 92307
Phone (760) 810-7590

2850 Telegraph Ave
Ste 120
Berkeley, CA 94705
Phone (510) 204-8140

350 John Muir Pkwy
Ste 160
Brentwood, CA 94513
Phone (925) 204-1920

1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

1189 E Herndon Ave
Ste 103
Fresno, CA 93720
Phone (559) 450-7777

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

795 El Camino Real
#1112
Palo Alto, CA 94301

1555 East St
Ste 200
Redding, CA 96001
Phone (530) 229-0911

151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 789-1505

505 Parnassus Ave
#114
San Francisco, CA 94143
Phone (415) 353-2273

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

3883 Airway Dr
Ste 220
Santa Rosa, CA 95403
Phone (707) 521-7750

10200 Trinity Pkwy
Ste 101
Stockton, CA 95219
Phone (209) 323-3488

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: dsudarshana661885@hisp.ehr.sutterhealth.org

Organizations & group practices 4

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 4

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": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1710440656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4053 LONE TREE WAY STE 100",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945316210",
            "telephone_number": "925-776-7725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4053 LONE TREE WAY STE 100",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945316210",
            "telephone_number": "925-776-7725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDARSHANA",
        "first_name": "DATTANAND",
        "middle_name": "MELUKOTE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-08",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A177777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

Verify at the official NPI Registry.