Organization Active NPI

West Coast Medicine and Cardiology Inc

  • Cardiovascular Disease Physician
  • Fremont, CA
National Provider Identifier
1912435173
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A50486 Issued in CA
Legal business name
WEST COAST MEDICINE AND CARDIOLOGY INC
Practice address
3155 Kearney St Ste 100
Fremont, CA 94538-2268
Phone
(510) 931-4310
Fax
(510) 894-0615
NPI assigned
May 31, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2021

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

Authorized official

Name
Rajesh Sam Suri, MDNPI 1790700987
Title
President
Phone
(510) 931-4310

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X A50486 CA Primary

Addresses

Primary practice location

3155 Kearney St Ste 100
Fremont, CA 94538-2268

Mailing address

43575 Mission Blvd # 709
Fremont, CA 94539-5831
Phone (510) 931-4310

Other practice location 1

27171 Calaroga Ave Ste 1-3
Hayward, CA 94545-4344
Phone (510) 931-4310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170717001982 CA Part B Supplier - Clinic/Group Practice 5597035030 Receives reassigned benefits from 7 practitioners
Practice locations: Hayward, CA; Fremont, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2072990West Coast Medicine & Cardiology Inc3155 Kearney St, Ste 100, Fremont, CA 94538Certificate of waiverFeb 9, 2028
05D2166502West Coast Medicine and Cardiology Inc27171 Calaroga Avenue, Suite 2, Hayward, CA 94545Certificate of waiverMay 19, 2027

National Provider Directory

National Provider Directory

Locations

2147 Mowry Ave
Ste D3
Fremont, CA 94538
Phone (510) 456-5794

27171 Calaroga Ave
Ste 13
Hayward, CA 94545

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JEBIBD

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1496188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621209600000",
    "number": "1912435173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43575 MISSION BLVD # 709",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945395831",
            "telephone_number": "510-931-4310",
            "fax_number": "510-894-0615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3155 KEARNEY ST STE 100",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382268",
            "telephone_number": "510-931-4310",
            "fax_number": "510-894-0615"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27171 Calaroga Ave Ste 1-3",
            "address_purpose": "LOCATION",
            "city": "Hayward",
            "state": "CA",
            "postal_code": "945454344",
            "country_code": "US",
            "telephone_number": "510-931-4310",
            "fax_number": "510-894-0615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WEST COAST MEDICINE AND CARDIOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-31",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A",
        "authorized_official_last_name": "SURI",
        "authorized_official_first_name": "RAJESH",
        "authorized_official_middle_name": "SAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-931-4310",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A50486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.