Manu Surendran, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R228294 Issued in MD

Practice address

25109 Jefferson Ave
Murrieta, CA 92562-8116

Phone

(951) 698-5765

Fax

(951) 698-0254

NPI assigned

Dec 30, 2021

Last updated

Nov 28, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• FHIR API: https://fhir4.healow.com/fhir/r4/CCACCA

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.

• Douglas F. Carrasco M.D. Inc.

  • Primary Care Clinic/Center
  • Temecula, CA
  • NPI 1295927408
  Medicare reassignment NPD (past)

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

{
    "created_epoch": "1640822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1952061020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25109 JEFFERSON AVE",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925628116",
            "telephone_number": "951-698-5765",
            "fax_number": "951-698-0254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25109 JEFFERSON AVE",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925628116",
            "telephone_number": "951-698-5765",
            "fax_number": "951-698-0254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURENDRAN",
        "first_name": "MANU",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-30",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R228294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucille Mary Suffern, B.S, CPHT, CPT1
• Nicole Sugimoto, MA
• Steven Ellis Sultan, PH.D.
• Summit Pediatric Medical Clinic Inc
• Sunshine Family Therapy Services, Inc.
• Taylor Susdorf, PT
• Sussex Radiology
• Tabitha Michelle Suter
• Mona Swallow
• Sumiyah Syed-Uddin, MSN, PNP

• Nurse Practitioner in Murrieta, CA
• Providers in Murrieta, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.