Individual provider Active NPI

Suman S. Kuppahally, MD

  • Cardiovascular Disease Physician
  • Los Gatos, CA
National Provider Identifier
1811073323
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A72494 Issued in CA
Practice address
15215 National Ave Ste 105
Los Gatos, CA 95032-2425
Phone
(408) 358-3458
Fax
(408) 356-6191
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A72494 CA
Cardiovascular Disease Physician 207RC0000X A72494 CA Primary

Addresses

Primary practice location

15215 National Ave Ste 105
Los Gatos, CA 95032-2425

Mailing address

15215 National Ave Ste 105
Los Gatos, CA 95032-2425
Phone (408) 358-3458

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
I20100803001261 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1254464886 Reassigns benefits to 1 organization
Practice locations: San Jose, CA

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of Utah School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15215 National Ave
Suite 105
Los Gatos, CA 95032-2425
Phone (408) 358-3458

2030 Forest Ave
Suite 110
San Jose, CA 95128-4833
Phone (707) 564-5190

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
72.71 of 100Reported as individual
Quality
57.69
Promoting interoperability
73
Improvement activities
40
Cost
73.84

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A72494CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Suman S Kuppahally, M.D. Inc Cardiovascular Disease CurrentSince Oct 1, 2020 Accepting new patients
El Camino Hospital Past Accepting new patients
El Camino Health Medical Network, LLC Past Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients
County of Santa Clara Past Accepting new patients

Locations

15215 National Ave
Ste 105
Los Gatos, CA 95032
Phone (408) 358-3458

2505 Samaritan Dr
Ste 600
San Jose, CA 95124
Phone (408) 358-3458

2030 Forest Ave
Ste 110
San Jose, CA 95128
Phone (408) 292-7777

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1811073323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15215 NATIONAL AVE STE 105",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322425",
            "telephone_number": "408-358-3458",
            "fax_number": "408-356-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15215 NATIONAL AVE STE 105",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322425",
            "telephone_number": "408-358-3458",
            "fax_number": "408-356-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPPAHALLY",
        "first_name": "SUMAN",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A72494",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A72494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

Verify at the official NPI Registry.