NPIMap

Individual provider Active NPI

Sundar Jagannath, M.D.

  • Medical Oncology Physician
  • New York, NY
National Provider Identifier
1174511687
Registry record updated Feb 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
209335 Issued in NY
Practice address
10 E 102ND St
New York, NY 10029
Phone
(212) 241-6756
Fax
(212) 241-3908
NPI assigned
Oct 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 209335 NY Primary

Addresses

Primary practice location

10 E 102ND St
New York, NY 10029

Mailing address

1 Gustave L Levy PL # 3000
New York, NY 10029-6504
Phone (212) 987-3100

Other practice location 1

1 Gustave L Levy Pl
New York, NY 10029-6504
Phone (212) 241-6756

Other identifiers 1

IdentifierTypeStateIssuer
01259874MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031115000020 NY Practitioner - Internal MedicinePractitioner - Medical Oncology 9638083561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Medical Oncology
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Gustave L Levy PL
New York, NY 10029-6504
Phone (212) 731-7650

10 E 102ND St
Tisch Dept of Mount Sinai
New York, NY 10029-6030
Phone (212) 844-8288

5 E 98TH St
Suite 6
New York, NY 10029-6501
Phone (212) 241-4812

5 E 98TH St 12TH Floor
Tisch Department of Mount Sinai
New York, NY 10029-6501
Phone (212) 241-8303

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Oct 5, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Oct 5, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

10 E 102nd St
New York, NY 10029
Phone (212) 241-5656

5 E 98th St
Fl 12
New York, NY 10029
Phone (212) 241-8303

325 W 15th St
New York, NY 10011
Phone (212) 523-5938

1470 Madison Ave
New York, NY 10029
Phone (212) 241-0806

5 E 98th St
Fl 10
New York, NY 10029
Phone (212) 241-2125

Networks

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

Organizations & group practices 3

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1174511687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL # 3000",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504",
            "telephone_number": "212-987-3100",
            "fax_number": "212-731-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 E 102ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10029",
            "telephone_number": "212-241-6756",
            "fax_number": "212-241-3908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Gustave L Levy Pl",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296504",
            "country_code": "US",
            "telephone_number": "212-241-6756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAGANNATH",
        "first_name": "SUNDAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NY",
            "license": "209335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01259874",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.