Individual provider Active NPI

Suseela Dasari, M.D.

  • Pediatrics Physician
  • Oxnard, CA
National Provider Identifier
1982658548
Registry record updated Sep 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
C51082 Issued in CA
Practice address
3641 W 5TH St
Oxnard, CA 93030-6424
Phone
(805) 985-5505
Fax
(805) 984-6095
NPI assigned
May 19, 2006
Last updated
Sep 19, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X C51082 CA Primary

Addresses

Primary practice location

3641 W 5TH St
Oxnard, CA 93030-6424

Mailing address

5855 Olivas Park Dr
Ventura, CA 93003-7672
Phone (805) 667-2801

Other identifiers 7

IdentifierTypeStateIssuer
RHM08608FMedicaidCA
RHM18553HMedicaidCA
050394OtherCABLUE CROSS
RHM08609FMedicaidCA
951683892OtherCAOTHER INSURANCE
00C510820MedicaidCA
ZZT40394FMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C51082CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Memorial Health System Past Accepting new patients
Community Memorial Health System Past Accepting new patients

Organizations & group practices 2

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348012800000",
    "number": "1982658548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 OLIVAS PARK DR",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930037672",
            "telephone_number": "805-667-2801",
            "fax_number": "805-667-2865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3641 W 5TH ST",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930306424",
            "telephone_number": "805-985-5505",
            "fax_number": "805-984-6095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DASARI",
        "first_name": "SUSEELA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2012-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C51082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM08608F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM18553H",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "050394",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM08609F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER INSURANCE",
            "identifier": "951683892",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C510820",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT40394F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.