Look up the most recent NPI and PECOS records

Sushrut Sujan Thiruvengadam

Internal Medicine

Allopathic & Osteopathic Physicians

10666 N Torrey Pines Rd, La Jolla, CA 92037-1027

PECOS Enrollment

Based on the most recent information from CMS, provider Sushrut Sujan Thiruvengadam is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1871947697
Provider Type
Individual
Full Name
Thiruvengadam, Sushrut Sujan
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
4/18/2016
Last Updated
9/11/2023

Contact Information

Practice Location

10666 N Torrey Pines Rd, La Jolla, CA 92037-1027

(858) 554-8955

Unlisted Fax

Mailing Location

10790 Rancho Bernardo Rd, San Diego, CA 92127-5705

(858) 554-8955

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207RG0100X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License A151339 California

Sushrut Sujan Thiruvengadam

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Branch, Laurel Lackey

Fehmi, Syed M.A.

Song, Erin Jongmin

Nodurft, Richard C.

Foroozan, Parviz

Kuo, Selena Zhao

Strum, Williamson B.

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Flick, Arnold Leab

Noureddin, Nabil