Dr Nayak has been a cardiologist in central Washington since 2009.  In 2025, he started Mission Medical NCW, partnering with rural hospitals and clinics to deliver outpatient cardiology care.  His interests lie in improving cardiac care delivery in resource-constrained settings through practice innovation and better care coordination.  He is also the co-founder and CEO of Coltrain, a clinical collaboration software platform connecting clinicians in any location or system around shared patients.