Individual provider Active NPI

Suparna Nanua, MD PHD

  • Clinical Pathology/Laboratory Medicine Physician
  • Round Rock, TX
National Provider Identifier
1104023084
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
License
307769 Issued in NY
Practice address
425 University Blvd Ste 500
Round Rock, TX 78665-1047
Phone
(512) 509-3750
NPI assigned
Jul 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X 04-35424 KS
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X 2010037369 MO
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X 307769 NY Primary

Addresses

Primary practice location

425 University Blvd Ste 500
Round Rock, TX 78665-1047

Mailing address

425 University Blvd Ste 500
Round Rock, TX 78665-1047
Phone (512) 509-3750

Other practice location 1

127 North St
Batavia, NY 14020-1631
Phone (585) 343-6030

Other practice location 2

1561 Long Pond Rd Ste 130
Rochester, NY 14626-4136
Phone (585) 723-7765

Other practice location 3

1200 Driving Park Ave
Newark, NY 14513-1090
Phone (315) 359-2847

Other practice location 4

2 Coulter Rd
Clifton Springs, NY 14432-1122
Phone (315) 462-1911

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sunanda.nanduri@rochesterregional.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20201224000666 NY Practitioner - Pathology 9931379054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

240 E 38TH St
New York, NY 10016-2708
Phone (212) 263-7300

530 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

560 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214
  • Long Island Community Hospital Hospital, Patchogue, NY, CCN 330141
  • Hospital for Special Surgery Hospital, New York, NY, CCN 330270
  • New York-Presbyterian Hospital Hospital, New York, NY, CCN 330101
  • Mount Sinai Beth Israel Hospital, New York, NY, CCN 330169

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
307769NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jun 1, 2025 Accepting new patients
New York University CurrentSince Jun 1, 2025 Accepting new patients

Locations

700 Hicksville Rd
Ste 205
Bethpage, NY 11714
Phone (646) 501-3325

Interoperability endpoints

  • Direct secure messaging: snanua742841@nyumc.direct-ci.com

Organizations & group practices 2

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 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1104023084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 UNIVERSITY BLVD STE 500",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651047",
            "telephone_number": "512-509-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 UNIVERSITY BLVD STE 500",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651047",
            "telephone_number": "512-509-3750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "127 North St",
            "address_purpose": "LOCATION",
            "city": "Batavia",
            "state": "NY",
            "postal_code": "140201631",
            "country_code": "US",
            "telephone_number": "585-343-6030",
            "fax_number": "585-344-7434",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1561 Long Pond Rd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146264136",
            "country_code": "US",
            "telephone_number": "585-723-7765",
            "fax_number": "585-723-7735",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 Driving Park Ave",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NY",
            "postal_code": "145131090",
            "country_code": "US",
            "telephone_number": "315-359-2847",
            "fax_number": "315-359-2806",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Coulter Rd",
            "address_purpose": "LOCATION",
            "city": "Clifton Springs",
            "state": "NY",
            "postal_code": "144321122",
            "country_code": "US",
            "telephone_number": "315-462-1911",
            "fax_number": "315-462-2430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NANUA",
        "first_name": "SUPARNA",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "KS",
            "license": "04-35424",
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "MO",
            "license": "2010037369",
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "NY",
            "license": "307769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sunanda.nanduri@rochesterregional.org",
            "affiliation": "N",
            "address_1": "1425 Portland Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146213011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.