Active NPI
Sarvesh Periyasamy, MD, PHD
- Surgery Physician
- Palo Alto, CA
National Provider Identifier
1770287658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- PTL14376
- Practice address
- 500 Pasteur Dr
Palo Alto, CA 94304-1048 - Phone
- (650) 723-4000
- NPI assigned
- Mar 27, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | PTL14376 | CA | Primary |
Addresses
Primary practice location
500 Pasteur Dr
Palo Alto, CA 94304-1048
Mailing address
911 Greenwood St
Holmen, WI 54636-9487
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTL14376 | CA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705881600000",
"number": "1770287658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "911 GREENWOOD ST",
"city": "HOLMEN",
"state": "WI",
"postal_code": "546369487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 PASTEUR DR",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943041048",
"telephone_number": "650-723-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERIYASAMY",
"first_name": "SARVESH",
"credential": "MD, PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-27",
"last_updated": "2024-01-22",
"certification_date": "2024-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "PTL14376",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palo Alto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.