Individual provider Active NPI

Priyanga Jayakumar, M.B.B.S

  • Family Medicine Physician
  • Visalia, CA
National Provider Identifier
1972036879
Registry record updated Sep 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A166928 Issued in CA
Practice address
305 E Center Ave
Visalia, CA 93291-6331
Phone
(559) 737-4700
NPI assigned
Apr 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X J15674970 KY
Family Medicine Physician 207Q00000X A166928 CA Primary

Addresses

Primary practice location

305 E Center Ave
Visalia, CA 93291-6331

Mailing address

11651 N Bella Verde Ave
Fresno, CA 93730-7037
Phone (313) 392-3644

Other practice location 1

1800 S A W Grimes Blvd
Baylor Scott & White Round Rock South Clinic
Round Rock, TX 78664-7424
Phone (512) 244-5729

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
I20200902002868 CA Practitioner - Family Practice 0042584765 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

16899 W Bernardo Dr
San Diego, CA 92127-1603
Phone (858) 499-2600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A166928CAMDFamily Medicine Physician
J15674970KYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Mar 25, 2024 Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network CurrentSince Jul 27, 2020 Accepting new patients
Family Healthcare Network CurrentSince Jul 27, 2020 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Family Medicine CurrentSince Mar 25, 2024 Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients

Locations

290 N Wayte Ln
Fresno, CA 93701
Phone (559) 459-4101

16899 W Bernardo Dr
San Diego, CA 92127
Phone (858) 499-2705

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

305 E Center Ave
Visalia, CA 93291
Phone (559) 737-4792

Organizations & group practices 6

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": "1491523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1972036879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11651 N BELLA VERDE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937307037",
            "telephone_number": "313-392-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E CENTER AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932916331",
            "telephone_number": "559-737-4700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 S A W Grimes Blvd",
            "address_2": "Baylor Scott & White Round Rock South Clinic",
            "address_purpose": "LOCATION",
            "city": "Round Rock",
            "state": "TX",
            "postal_code": "786647424",
            "country_code": "US",
            "telephone_number": "512-244-5729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAYAKUMAR",
        "first_name": "PRIYANGA",
        "name_prefix": "Dr.",
        "credential": "M.B.B.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-07",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "KY",
            "license": "J15674970",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A166928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.