Active NPI
Suma Chandra Kannabiran, MD
- Diagnostic Radiology Physician
- Worcester, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 279413
- Practice address
- 55 Lake Avenue North
Department of Radiology
Worcester, MA 01655 - Phone
- (508) 334-1000
- NPI assigned
- Apr 22, 2011
- Last updated
- May 26, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Diagnostic Radiology Physician | 2085R0202X | 279413 | MA | Primary |
Addresses
Primary practice location
55 Lake Avenue North
Department of Radiology
Worcester, MA 01655
Mailing address
PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110134748A | Medicaid | MA |
Other names 1
- Dr. Suma Kanakalalita Chandra
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | skannabiran241217@UmassMemorial.direct-ci.com | ||
| FHIR URL | https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA, NH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Georgetown University School of Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Hutchinson Dr
Danvers, MA 01923-3748
Phone (978) 354-4181
102 Endicott St
Danvers, MA 01923-3623
Phone (978) 354-4181
15 Corporate Park Dr
Pembroke, MA 02359-1966
Phone (781) 826-8065
170 Governors Ave
Medford, MA 02155-1643
Phone (781) 395-4909
2014 Washington St
Newton, MA 02462-1607
Phone (617) 243-6000
480 Lynnfield St
Lynn, MA 01904-1419
Phone (781) 342-4386
81 Highland Ave
Salem, MA 01970-2714
Phone (978) 354-4181
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 279413 | MA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern Massachusetts Regional MRI, Limited Partnership | Current | Accepting new patients | |
| Shields Healthcare of Cambridge, Inc. | Current | Accepting new patients | |
| Mass General Brigham Medical Group Suburban Massachusetts Inc | Current | Accepting new patients | |
| Mass General Brigham Community Physicians Inc | Current | Accepting new patients | |
| Newton Wellesley Hospital | Current | Accepting new patients |
Locations
170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000
2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000
399 Revolution Dr
Ste 1010
Somerville, MA 02145
Phone (857) 282-0165
30 Tuscan Blvd
Salem, NH 03079
Phone (857) 282-8100
Interoperability endpoints
- kannabiran.suma.nwh@direct.partners.masshiway.net
- skannabiran241217@umassmemorial.direct-ci.com
Organizations & group practices 5
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.
-
- Cardiovascular Disease Physician
- Medford, MA
- NPI 1548638265
NH
-
- Family Medicine Physician
- Newton, MA
- NPI 1538191218
-
- General Acute Care Hospital
- Newton, MA
- NPI 1952845521
-
dba Cambridge Regional MRI Center
- Magnetic Resonance Imaging (MRI) Clinic/Center
- Brighton, MA
- NPI 1134178312
-
dba Brockton Regional MRI Center
- Magnetic Resonance Imaging (MRI) Clinic/Center
- Brockton, MA
- NPI 1013966282
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Boston, MA
- NPI 1790717650
-
- General Acute Care Hospital
- Newton, MA
- NPI 1992737761
-
dba Salem Hospital
- General Acute Care Hospital
- Salem, MA
- NPI 1730121633
-
- General Acute Care Hospital
- Boston, MA
- NPI 1023049236
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621987200000",
"number": "1053602235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 415348",
"city": "BOSTON",
"state": "MA",
"postal_code": "022415348",
"telephone_number": "800-225-8885",
"fax_number": "508-334-1977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 LAKE AVENUE NORTH",
"address_2": "DEPARTMENT OF RADIOLOGY",
"city": "WORCESTER",
"state": "MA",
"postal_code": "01655",
"telephone_number": "508-334-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANNABIRAN",
"first_name": "SUMA",
"middle_name": "CHANDRA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-22",
"last_updated": "2021-05-26",
"certification_date": "2021-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MA",
"license": "279413",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110134748A",
"state": "MA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "skannabiran241217@UmassMemorial.direct-ci.com",
"affiliation": "N",
"address_1": "55 Lake Avenue North",
"address_2": "Department of Radiology",
"city": "Worcester",
"state": "MA",
"country_code": "US",
"postal_code": "01655",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "55 Lake Avenue North",
"address_2": "Department of Radiology",
"city": "Worcester",
"state": "MA",
"country_code": "US",
"postal_code": "01655",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "SUMA",
"last_name": "CHANDRA",
"middle_name": "KANAKALALITA",
"prefix": "DR.",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.