Individual provider Active NPI

Kavita Sharma, M.D.

  • Internal Medicine Physician
  • Campbell, CA
National Provider Identifier
1952401960
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A71740 Issued in CA
Practice address
221 E Hacienda Ave
Suite D
Campbell, CA 95008-6625
Phone
(408) 376-3380
Fax
(408) 376-3801
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A71740 CA Primary

Addresses

Primary practice location

221 E Hacienda Ave
Suite D
Campbell, CA 95008-6625

Mailing address

2386 Bentley Ridge Dr
San Jose, CA 95138-2435
Phone (530) 294-1136

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
I20050310000914 CA Practitioner - Internal Medicine 6800840950 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wayne State University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Bay Orthopedic and Sports Medicine Clinic, IncGroup PAC ID 6901974351, 3 clinicians

Practice addresses (Care Compare)

333 Oconnor Dr
San Jose, CA 95128-1623
Phone (408) 376-3380

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A71740CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
El Camino Hospital Past Accepting new patients
El Camino Hospital Past Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1952401960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2386 BENTLEY RIDGE DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951382435",
            "telephone_number": "530-294-1136",
            "fax_number": "530-294-1143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 E HACIENDA AVE",
            "address_2": "SUITE D",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950086625",
            "telephone_number": "408-376-3380",
            "fax_number": "408-376-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARMA",
        "first_name": "KAVITA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A71740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

Verify at the official NPI Registry.