NPIMap

Shyam Sundar Bhupalam, MBBS

Individual provider Active NPI Nephrology Physician · Duluth, MN

NPI 1124078332 · NPPES record last updated Apr 8, 2022

Key facts

NPI
1124078332
Entity type
Individual (NPI type 1)
Primary specialty
Nephrology Physician 207RN0300X
License
70714 (MN)
Practice address
400 E 3Rd St
Duluth, MN 55805-1951
Phone
(218) 786-8364
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 41

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.

View all 41

Hospital & facility affiliations 9

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

Medicare Care Compare profile

Specialty
Nephrology
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Duluth Clinic LTD (1,135 clinicians)

Practice addresses (Care Compare)

1615 Maple LN
Suite 1
Ashland, WI 54806-3630
Phone (715) 685-7500

4855 W Arrowhead Rd
Hermantown, MN 55811-3936
Phone (218) 786-3540

Hospital & facility affiliations

  • FMC Dialysis - Eveleth Dialysis facility · Eveleth, MN · CCN 242549
  • Fresenius Medical Care of Hibbing Dialysis facility · Hibbing, MN · CCN 242561
  • Fresenius Medical Care - Cloquet Dialysis facility · Cloquet, MN · CCN 242604
  • Essentia Health Duluth Hospital · Duluth, MN · CCN 240019
  • Essentia Health Virginia Hospital · Virginia, MN · CCN 240084
  • Essentia Health St Mary'S Medical Center Hospital · Duluth, MN · CCN 240002
  • St Marys Hospital Superior Hospital · Superior, WI · CCN 521329
  • Essentia Health Northern Pines Medical Center Hospital · Aurora, MN · CCN 241340

Medicare participation

Medicare fee-for-service enrollment
Enrolled (3 enrollments) in MI, MN, WI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20050422000965 MI Practitioner - Nephrology 2163334806 Reassigns benefits to 1 organization
I20220316000096 MN Practitioner - Nephrology 2163334806 Reassigns benefits to 5 organizations
I20220426000430 WI Practitioner - Nephrology 2163334806 Reassigns benefits to 3 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301053592MIMDNephrology Physician
70714MNMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W. Sparrow Hospital Association Current Accepting new patients
The Duluth Clinic, LTD. Current
since Apr 25, 2022		 Accepting new patients
The Duluth Clinic, LTD Current
since Apr 25, 2022		 Accepting new patients
Essentia Health Moose Lake Current
since Apr 25, 2022		 Accepting new patients
Essentia Health Moose Lake Current
since Apr 25, 2022		 Accepting new patients
Deer River Healthcare Center, Inc. Current
since Apr 25, 2022		 Accepting new patients
St. Mary'S Hospital of Superior Current
since Apr 25, 2022		 Accepting new patients
Deer River Healthcare Center, Inc. Current Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
The Duluth Clinic, LTD Current
since Jul 1, 2024		 Accepting new patients
Edward W Sparrow Hospital Association Nephrology Current
since Dec 31, 2014		 Accepting new patients
Edward W Sparrow Hospital Association Current
since Dec 31, 2014		 Accepting new patients
Moose Lake Community Hospital District Current Accepting new patients
St. Mary'S Hospital of Superior Current Accepting new patients
St. Mary'S Duluth Clinic Health System Current Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
Deer River Healthcare Center, Inc Current
since Apr 25, 2022		 Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

2601 Coolidge Rd
Ste B
East Lansing, MI 48823
Phone (517) 253-4050

2622 Heartland Blvd
Ionia, MI 48846
Phone (616) 522-0265

1200 E Michigan Ave
Ste 700
Lansing, MI 48912
Phone (517) 364-5888

1540 Lake Lansing Rd
Ste 204
Lansing, MI 48912
Phone (517) 913-3840

1200 E Michigan Ave
Ste 500
Lansing, MI 48912
Phone (517) 364-5123

975 E Townsend Rd
Saint Johns, MI 48879
Phone (989) 224-2662

115 10th Ave NE
#A
Deer River, MN 56636
Phone (218) 246-8275

115 10th Ave NE
Deer River, MN 56636
Phone (218) 246-2900

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

4855 W Arrowhead Rd
Hermantown, MN 55811
Phone (218) 786-3540

730 E 34th St
Hibbing, MN 55746
Phone (218) 262-3425

4572 County Road 61
Moose Lake, MN 55767
Phone (218) 485-4481

1101 9th St N
Virginia, MN 55792
Phone (218) 305-0000

603 9th St N
Virginia, MN 55792
Phone (218) 741-3013

1615 Maple Ln
Ste 1
Ashland, WI 54806
Phone (715) 685-7500

15495 County Road B
Hayward, WI 54843
Phone (715) 634-2641

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Interoperability endpoints

  • Direct secure messaging: sbhupalam6909@sparrowdirecthie.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 4301053592 MI
Nephrology Physician 207RN0300X 1717-320 WI
Nephrology Physician 207RN0300X 70714 MN Yes

Addresses

Primary practice location

400 E 3Rd St
Duluth, MN 55805-1951

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Other providers in Duluth, MN

All providers in Duluth, MN · Nephrology Physician in Minnesota

Sources for this page

Verify at the official NPI Registry.