Individual provider Active NPI

Ananthraj Subramanya, MD

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1104349851
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
29888 Issued in WV
Practice address
234 E 149TH St
Bronx, NY 10451-5504
Phone
(732) 762-2122
NPI assigned
Jul 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 29888 WV Primary

Addresses

Primary practice location

234 E 149TH St
Bronx, NY 10451-5504

Mailing address

2562 Laconia Ave
Bronx, NY 10469-1409

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200930000117 WV Practitioner - Internal Medicine 8224457916
I20231206002714 AZ Practitioner - Internal Medicine 8224457916 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yuma Regional Medical CenterGroup PAC ID 2062314826, 367 clinicians

Practice addresses (Care Compare)

2400 S Ave a
Yuma, AZ 85364-7127
Phone (928) 344-2000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Yuma Regional Medical Center CurrentSince Dec 3, 2023 Accepting new patients

Locations

2400 S Avenue A
Yuma, AZ 85364
Phone (928) 336-7100

Interoperability endpoints

  • Direct secure messaging: ananthraj.subramanya@wvafn.hcadirect.net

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 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": "1500854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1104349851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2562 LACONIA AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104691409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 E 149TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515504",
            "telephone_number": "732-762-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUBRAMANYA",
        "first_name": "ANANTHRAJ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-24",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "29888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.