Summit Medical Associates LLC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

SUMMIT MEDICAL ASSOCIATES LLC

Practice address

4656 W Jefferson Blvd
Suite 125
Fort Wayne, IN 46804-6857

Phone

(260) 434-1177

Fax

(888) 854-6745

NPI assigned

Sep 14, 2006

Last updated

Dec 29, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bhaktavatsala R Apuri, M.D.

Title

Owner

Phone

(260) 434-1177

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

Interoperability endpoints

• Direct secure messaging: bapuri@sma.ssdirect.aprima.com

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shilpa Kashyap, MD

  • Diagnostic Radiology Physician
  • Lagrange, IN
  • NPI 1003888116
  NPD (past)
• Sheresa Wilson, PA-C, LMHCA

  • Physician Assistant
  • Fort Wayne, IN
  • NPI 1114001237
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609200000000",
    "number": "1063517084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4656 W JEFFERSON BLVD",
            "address_2": "SUITE 125",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046857",
            "telephone_number": "260-434-1177",
            "fax_number": "888-854-6745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4656 W JEFFERSON BLVD",
            "address_2": "SUITE 125",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046857",
            "telephone_number": "260-434-1177",
            "fax_number": "888-854-6745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT MEDICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A",
        "authorized_official_last_name": "APURI",
        "authorized_official_first_name": "BHAKTAVATSALA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-434-1177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200468080A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bapuri@SMA.ssdirect.aprima.com",
            "affiliation": "N",
            "endpointDescription": "direct email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4656 W Jefferson Blvd",
            "address_2": "Suite 125",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468046857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Cardiovascular Disease Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Cardiovascular Disease Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.