NPIMap

Individual provider Active NPI

Sudeep K Siddappa Malleshappa, M.D.,

  • Hematology & Oncology Physician
  • Springfield, MA
National Provider Identifier
1073928784
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
271292 Issued in MA
Practice address
3350 Main St
Springfield, MA 01107-1112
Phone
(413) 794-9338
Fax
(413) 794-9754
NPI assigned
Jun 23, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 271292 MA
Hematology & Oncology Physician 207RH0003X 271292 MA Primary

Addresses

Primary practice location

3350 Main St
Springfield, MA 01107-1112

Mailing address

280 Chestnut Street
2ND FL
Springfield, MA 01199-1001
Phone (413) 794-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20220526000840 MA Practitioner - Hematology/Oncology 4688945777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baystate Medical Practices IncGroup PAC ID 5991602971, 1,350 clinicians

Practice addresses (Care Compare)

3350 Main St
Springfield, MA 01107-1112
Phone (413) 794-9338

Hospital & facility affiliations

  • Baystate Hospice Hospice, West Springfield, MA, CCN 221521
  • Baystate Medical Center Hospital, Springfield, MA, CCN 220077
  • Baystate Franklin Medical Center Hospital, Greenfield, MA, CCN 220016
  • Baystate Wing Hospital Hospital, Palmer, MA, CCN 220030
  • Baystate Noble Hospital Hospital, Westfield, MA, CCN 220065
  • Cooley Dickinson Hospital Inc,the Hospital, Northampton, MA, CCN 220015

National Provider Directory

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

Organizations & group practices 1

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 8

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

NPI Registry JSON

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1073928784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT STREET",
            "address_2": "2ND FL",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991001",
            "telephone_number": "413-794-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 MAIN ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071112",
            "telephone_number": "413-794-9338",
            "fax_number": "413-794-9754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDAPPA MALLESHAPPA",
        "first_name": "SUDEEP",
        "middle_name": "K",
        "credential": "M.D.,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-23",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MA",
            "license": "271292",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MA",
            "license": "271292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.