Individual provider Active NPI

Ruwan Kiringoda, M.D.

  • Otolaryngology Physician
  • Fremont, CA
National Provider Identifier
1982917225
Registry record updated Jun 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A120942 Issued in CA
Practice address
3200 Kearney St
Fremont, CA 94538-2299
Phone
(510) 490-1222
NPI assigned
Jul 15, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 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 263011 MA
Otolaryngology Physician 207Y00000X A120942 CA Primary

Addresses

Primary practice location

3200 Kearney St
Fremont, CA 94538-2299

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (510) 490-1222

Other practice location 1

243 Charles St
Boston, MA 02114-3002
Phone (617) 523-7900

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
I20170802001031 CA Practitioner - Otolaryngology 3274764592 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Ohio State University College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, shared by 16 NPIs, 3,783 clinicians

Practice addresses (Care Compare)

3200 Kearney St
Fremont, CA 94538-2299
Phone (510) 490-1222

Hospital & facility affiliations

  • Peninsula Medical Center Hospital, Burlingame, CA, CCN 050007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
120942CAMDMarriage & Family Therapist
A120942CAMDOtolaryngology Physician
263011MAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Jul 10, 2017 Accepting new patients
Sutter Bay Medical Foundation Current Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jul 10, 2017 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jul 10, 2017 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jul 10, 2017 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Jul 10, 2017 Accepting new patients
Sutter Bay Medical Foundation Current Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients
Washington Township Hospital District Past Accepting new patients

Locations

4050 Dublin Blvd
Dublin, CA 94568
Phone (925) 875-6100

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

3120 Kearney St
Fremont, CA 94538
Phone (650) 498-3600

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

701 E El Camino Real
#1
Mountain View, CA 94040
Phone (650) 404-8440

2350 W El Camino Real
Fl 2
Mountain View, CA 94040
Phone (650) 691-6174

701 E El Camino Real
Mountain View, CA 94040
Phone (650) 404-8370

795 El Camino Real
#1112
Palo Alto, CA 94301

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

301 Industrial Rd
#1
San Carlos, CA 94070
Phone (650) 404-8455

2581 Samaritan Dr
Ste 308
San Jose, CA 95124
Phone (408) 355-1700

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: rkiringoda98373@direct.whhs.com

Organizations & group practices 9

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591056000000",
    "number": "1982917225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "510-490-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 KEARNEY ST",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382299",
            "telephone_number": "510-490-1222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "243 Charles St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021143002",
            "country_code": "US",
            "telephone_number": "617-523-7900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRINGODA",
        "first_name": "RUWAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-15",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "263011",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A120942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.