Individual provider Active NPI

Sumitra S Khandelwal, MD

  • Ophthalmology Physician
  • Houston, TX
National Provider Identifier
1093971079
Registry record updated Nov 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
P6988 Issued in TX
Practice address
1977 Butler Blvd
Houston, TX 77030-4101
Phone
(404) 862-9626
NPI assigned
Jul 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X P6988 TX Primary

Addresses

Primary practice location

1977 Butler Blvd
Houston, TX 77030-4101

Mailing address

9801 Dupont Ave S
Suite 425
Bloomington, MN 55431-3100
Phone (952) 888-5800

Other identifiers 1

IdentifierTypeStateIssuer
P6988OtherTXTX MEDICAL LICENSE

Other names 1

  • Sumtira Subramanyam Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address skhandelwal13010@bcm.ghhdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20130812000223 TX Practitioner - Ophthalmology 5799932661 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Texas Medical School at Houston, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baylor College of MedicineGroup PAC ID 8022243971, 1,230 clinicians

Practice addresses (Care Compare)

1977 Butler Blvd
Houston, TX 77030-4101

1977 Butler Boulevard
Houston, TX 77030-4101

1977 Butler Boulevard 6TH Floor
200 BCM Physicians
Houston, TX 77030-4101
Phone (713) 798-6131

2 Greenway PLZ
Suite 900
Houston, TX 77046-0205

7200 Cambridge St
Houston, TX 77030-4202

Hospital & facility affiliations

  • Baylor St Lukes Medical Center Hospital, Houston, TX, CCN 450193

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery102

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P6988TXMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine Ophthalmology CurrentSince Jan 27, 2014 Accepting new patients
Baylor College of Medicine Current Accepting new patients
Baylor College of Medicine Ophthalmology CurrentSince Aug 12, 2013 Accepting new patients
Baylor College of Medicine CurrentSince Aug 12, 2013 Accepting new patients
Baylor College of Medicine CurrentSince Jan 27, 2014 Accepting new patients
Baylor College of Medicine Past Accepting new patients

Locations

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

6701 Fannin St
Ste 510
Houston, TX 77030
Phone (832) 822-3230

1977 Butler Blvd
Houston, TX 77030
Phone (713) 798-4857

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

1977 Butler Blvd
Fl 2
Houston, TX 77030
Phone (713) 798-7321

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

Organizations & group practices 6

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 1

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": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1093971079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9801 DUPONT AVE S",
            "address_2": "SUITE 425",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554313100",
            "telephone_number": "952-888-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1977 BUTLER BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304101",
            "telephone_number": "404-862-9626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANDELWAL",
        "first_name": "SUMITRA",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-30",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "P6988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX MEDICAL LICENSE",
            "identifier": "P6988",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skhandelwal13010@bcm.ghhdirect.net",
            "affiliation": "N",
            "address_1": "1977 Butler Blvd",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770304101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SUMTIRA",
            "last_name": "SUBRAMANYAM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.