Individual provider Active NPI

Soumya Ganapathy, MD

  • Emergency Medicine Physician
  • Burlington, MA
National Provider Identifier
1093811648
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
238614 Issued in MA
Practice address
41 Mall Rd
Burlington, MA 01805-3017
Phone
(781) 744-8000
NPI assigned
Sep 14, 2006
Last updated
Apr 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X D61187 MD
Emergency Medicine Physician 207P00000X 238614 MA Primary
Obesity Medicine (Preventive Medicine) Physician 2083B0002X 238614 MA

Addresses

Primary practice location

41 Mall Rd
Burlington, MA 01805-3017

Mailing address

200 Unicorn Park Dr Ste 401
Woburn, MA 01801-3342
Phone (781) 756-6760

Other practice location 1

16251 Sylvester Rd SW
Burien, WA 98166-3017
Phone (206) 244-9970

Other identifiers 1

IdentifierTypeStateIssuer
404767200MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090429000236 MA Practitioner - Emergency Medicine 6709778459 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Missouri, Kansas City, School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

41 Mall Rd
Burlington, MA 01805-0001
Phone (781) 744-8400

480 Maple St
Danvers, MA 01923-4065
Phone (978) 304-8451

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D61187MDMDEmergency Medicine Physician
238614MAMDObesity Medicine (Preventive Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Physician Associates, Inc CurrentSince Dec 20, 2021 Accepting new patients
Neighborhealth Corporation CurrentSince Mar 2, 2020 Accepting new patients
Internal Medical Associates-Ebnhc CurrentSince Mar 2, 2020 Accepting new patients
Medlantic Healthcare Group Emergency Medicine Past Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

41 Mall Rd
#6517
Burlington, MA 01805

10 Grove St
East Boston, MA 02128
Phone (617) 569-5800

500 Salem St
Wilmington, MA 01887
Phone (978) 988-6000

200 Unicorn Park Dr
Woburn, MA 01801
Phone (781) 782-1300

200 Unicorn Park Dr
Ste 401
Woburn, MA 01801
Phone (781) 756-6760

Interoperability endpoints

  • Direct secure messaging: sganapathy26633@direct.bilh.masshiway.net

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.

Hospital & facility affiliations 2

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1093811648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 UNICORN PARK DR STE 401",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018013342",
            "telephone_number": "781-756-6760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MALL RD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018053017",
            "telephone_number": "781-744-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16251 Sylvester Rd SW",
            "address_purpose": "LOCATION",
            "city": "Burien",
            "state": "WA",
            "postal_code": "981663017",
            "country_code": "US",
            "telephone_number": "206-244-9970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANAPATHY",
        "first_name": "SOUMYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2023-04-27",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D61187",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "238614",
            "primary": true
        },
        {
            "code": "2083B0002X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": "MA",
            "license": "238614",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "404767200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.