NPIMap

Individual provider Active NPI

Mina Sun, MD

  • Internal Medicine Physician
  • Glenville, NY
National Provider Identifier
1043234271
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1970281 Issued in NY
Practice address
115 Saratoga Rd Ste 200
Glenville, NY 12302-4224
Phone
(518) 243-3360
Fax
(518) 243-3375
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 1970281 NY Primary

Addresses

Primary practice location

115 Saratoga Rd Ste 200
Glenville, NY 12302-4224

Mailing address

463 Saratoga Rd
Scotia, NY 12302-5200
Phone (518) 399-2233

Other identifiers 2

IdentifierTypeStateIssuer
P00092117OtherNYRAILROAD MEDICARE
03177066MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20071009000781 NY Practitioner - Family PracticePractitioner - Internal Medicine 4082700885 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Virginia Commonwealth University, School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sun Medical Care PCGroup PAC ID 2961598966, 2 clinicians

Practice addresses (Care Compare)

463 Saratoga Rd
Scotia, NY 12302-5200
Phone (518) 399-2233

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions37
Removal of nail tissue18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1970281NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ellis Hospital CurrentSince May 1, 2019 Accepting new patients

Locations

115 Saratoga Rd
Ste 200
Glenville, NY 12302
Phone (518) 243-3360

1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916

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 and National Provider Directory roles.

Hospital & facility affiliations 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1043234271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "463 SARATOGA RD",
            "city": "SCOTIA",
            "state": "NY",
            "postal_code": "123025200",
            "telephone_number": "518-399-2233",
            "fax_number": "518-399-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 SARATOGA RD STE 200",
            "city": "GLENVILLE",
            "state": "NY",
            "postal_code": "123024224",
            "telephone_number": "518-243-3360",
            "fax_number": "518-243-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUN",
        "first_name": "MINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "1970281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00092117",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03177066",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenville, NY

Sources for this page

Verify at the official NPI Registry.