Individual provider Active NPI

Soma M Brahmanandam, M.D.

  • Surgery Physician
  • Marlborough, MA
National Provider Identifier
1164586392
Registry record updated Apr 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
230626 Issued in MA
Practice address
15 Redbud Way
Apt. #23
Marlborough, MA 01752
Phone
(508) 277-1985
NPI assigned
Dec 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 230626 MA Primary

Addresses

Primary practice location

15 Redbud Way
Apt. #23
Marlborough, MA 01752

Mailing address

15 Redbud Way
Apt. #23
Marlborough, MA 01752
Phone (508) 277-1985

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MA2 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
I20150520001816 NY Practitioner - Vascular SurgeryPractitioner - General Surgery 2668617739 Reassigns benefits to 8 organizations
I20220526000468 MA Practitioner - Vascular Surgery 2668617739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Warren Alpert Medical School of Brown University, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Berkshire Faculty Services IncGroup PAC ID 8224068424, 276 clinicians

Practice addresses (Care Compare)

777 N St
Berkshire Surgical Services of BMC
Pittsfield, MA 01201-4147
Phone (413) 445-6420

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
230626MAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Berkshire Faculty Services Inc CurrentSince May 2, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai Surgery CurrentSince Jan 27, 2018 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Feb 24, 2018 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Oct 1, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai Surgery CurrentSince Oct 1, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai Surgery CurrentSince Jan 1, 2016 Accepting new patients
Fairview Hospital CurrentSince May 2, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai Surgery CurrentSince Feb 24, 2018 Accepting new patients
Metropolitan Medical Practice Plan PC CurrentSince Nov 1, 2017 Accepting new patients
Hillcrest Family Health Center Surgery Past Accepting new patients

Locations

780 S Main St
Ste 2
Gt Barrington, MA 01230
Phone (413) 447-2498

725 North St
Pittsfield, MA 01201
Phone (413) 447-2839

777 North St
Ste 201A
Pittsfield, MA 01201
Phone (413) 499-8551

7901 Broadway
Rm A119
Elmhurst, NY 11373
Phone (718) 334-3915

4500 Parsons Blvd
Flushing, NY 11355
Phone (718) 670-5631

13620 38th Ave
Flushing, NY 11354
Phone (718) 353-7701

3711 Queens Blvd
Long Island City, NY 11101
Phone (718) 361-5100

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

10 Union Sq E
Ste 2P
New York, NY 10003
Phone (212) 844-8200

150 E 42nd St
New York, NY 10017
Phone (212) 661-8139

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

1901 1st Ave
New York, NY 10029
Phone (212) 230-6262

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: somabrahmanandam@bfs.medalliesdirect.net

Organizations & group practices 15

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 15

Hospital & facility affiliations 3

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": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271808000000",
    "number": "1164586392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 REDBUD WAY",
            "address_2": "APT. #23",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "01752",
            "telephone_number": "508-277-1985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 REDBUD WAY",
            "address_2": "APT. #23",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "01752",
            "telephone_number": "508-277-1985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAHMANANDAM",
        "first_name": "SOMA",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2010-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "230626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlborough, MA

Sources for this page

Verify at the official NPI Registry.