NPIMap

Individual provider Active NPI

Rajagopal Keerthy Sunder, M.D.

  • Psychiatry Physician
  • Villa Park, CA
National Provider Identifier
1972572824
Registry record updated Jun 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A94223 Issued in CA
Practice address
17853 Santiago Blvd Ste 107
Villa Park, CA 92861-4199
Phone
(510) 685-2022
NPI assigned
Mar 14, 2006
Last updated
Jun 4, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A94223 CA Primary

Addresses

Primary practice location

17853 Santiago Blvd Ste 107
Villa Park, CA 92861-4199

Mailing address

3060 El Cerrito PLZ
Suite 266
El Cerrito, CA 94530-4011
Phone (510) 685-2022

Other identifiers 1

IdentifierTypeStateIssuer
101426267MedicaidPA

Other names 1

  • Dr. Keerthy Sunder Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120427000128 CA Practitioner - Psychiatry 0941228605 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Karma TMS PCGroup PAC ID 0840662821, 2 clinicians

Practice addresses (Care Compare)

560 S Paseo Dorotea
Suite 4B
Palm Springs, CA 92264-1434
Phone (951) 395-2321

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A94223CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hi-Desert Memorial Health Care District CurrentSince Feb 26, 2024 Accepting new patients
Karma TMS PC Psychiatry CurrentSince Dec 29, 2022 Accepting new patients
Hi -Desert Memorial Health Care District Current Accepting new patients
New Day Institute PastSince Oct 24, 2019 Accepting new patients
Wpic Physician Practice Corp Inc Past Accepting new patients
Karma Doctors & Associates, P.C. Psychiatry Past Accepting new patients
Hi-Desert Memorial Health Care District Past Accepting new patients
Brisas Iop, LLC Past Accepting new patients

Locations

3060 El Cerrito Plz
El Cerrito, CA 94530
Phone (415) 710-7728

560 S Paseo Dorotea
Ste 4
Palm Springs, CA 92264
Phone (510) 685-2022

560 S Paseo Dorotea
Ste 4B
Palm Springs, CA 92264
Phone (951) 395-2321

35400 Bob Hope Dr
Ste 206B
Rancho Mirage, CA 92270

72724 29 Palms Hwy
Ste 107B
Twentynine Palms, CA 92277
Phone (760) 760-5675

58375 29 Palms Hwy
Yucca Valley, CA 92284
Phone (442) 234-6821

58383 29 Palms Hwy
Ste 101
Yucca Valley, CA 92284
Phone (760) 820-9229

6530 La Contenta Rd
Ste 100
Yucca Valley, CA 92284
Phone (760) 820-9229

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 11

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1972572824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3060 EL CERRITO PLZ",
            "address_2": "SUITE 266",
            "city": "EL CERRITO",
            "state": "CA",
            "postal_code": "945304011",
            "telephone_number": "510-685-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17853 SANTIAGO BLVD STE 107",
            "city": "VILLA PARK",
            "state": "CA",
            "postal_code": "928614199",
            "telephone_number": "510-685-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDER",
        "first_name": "RAJAGOPAL",
        "middle_name": "KEERTHY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A94223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101426267",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEERTHY",
            "last_name": "SUNDER",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Villa Park, CA

Sources for this page

Verify at the official NPI Registry.