Individual provider Active NPI

Sugata Bhattacharjee, AUD

  • Audiologist-Hearing Aid Fitter
  • Derry, NH
National Provider Identifier
1114171840
Registry record updated Jun 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
A555 Issued in NH
Practice address
61 Lawrence Rd
Derry, NH 03038-4190
Phone
(703) 380-2867
NPI assigned
Nov 7, 2008
Last updated
Jun 3, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X SP891AU MA
Audiologist-Hearing Aid Fitter 237600000X A555 NH Primary

Addresses

Primary practice location

61 Lawrence Rd
Derry, NH 03038-4190

Mailing address

61 Lawrence Rd
Derry, NH 03038-4190
Phone (703) 380-2867

Other identifiers 2

IdentifierTypeStateIssuer
A559OtherNHSTATE LICENSE
SP891AUOtherMASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260408000977 CT Practitioner - Qualified Audiologist 5496220345 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

28 Crescent St
Middletown, CT 06457-3650

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP891AUMAMDAudiologist
A555NHMDAudiologist-Hearing Aid Fitter

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1226016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307059200000",
    "number": "1114171840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 LAWRENCE RD",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030384190",
            "telephone_number": "703-380-2867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 LAWRENCE RD",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030384190",
            "telephone_number": "703-380-2867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHATTACHARJEE",
        "first_name": "SUGATA",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-07",
        "last_updated": "2011-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MA",
            "license": "SP891AU",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NH",
            "license": "A555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A559",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "SP891AU",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Derry, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.