Individual provider Active NPI

Marta Anna Sivarajah, FNP-C

  • Family Nurse Practitioner
  • San Jose, CA
National Provider Identifier
1841825148
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95013302 Issued in CA
Practice address
255 N. White Rd.
San Jose, CA 95127-1966
Phone
(408) 503-7600
Fax
(408) 503-7650
NPI assigned
Mar 6, 2020
Last updated
Jul 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95013302 CA Primary

Addresses

Primary practice location

255 N. White Rd.
San Jose, CA 95127-1966

Mailing address

35855 Burning Tree Dr
Newark, CA 94560-1527
Phone (404) 935-2276

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95013302CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Encore Wellness Physical Therapy, Inc. CurrentSince Aug 2, 2020 Accepting new patients
Caremore Health Plan Family PastSince Jul 13, 2020 Accepting new patients

Locations

10000 Lakewood Blvd
Downey, CA 90240
Phone (562) 862-3684

255 N White Rd
San Jose, CA 95127
Phone (408) 503-7600

255 N White Rd
Ste 200
San Jose, CA 95127
Phone (408) 503-7600

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1583452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1841825148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35855 BURNING TREE DR",
            "city": "NEWARK",
            "state": "CA",
            "postal_code": "945601527",
            "telephone_number": "404-935-2276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N. WHITE RD.",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951271966",
            "telephone_number": "408-503-7600",
            "fax_number": "408-503-7650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVARAJAH",
        "first_name": "MARTA",
        "middle_name": "ANNA",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-06",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95013302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.