Suba Pathmanathan, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35.141212 Issued in OH

Practice address

120 McMillen Dr
Newark, OH 43055-1809

Phone

(220) 564-4805

Fax

(220) 564-4811

NPI assigned

Jul 10, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN, OH2 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

Specialty

Internal Medicine

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Licking Memorial Health ProfessionalsGroup PAC ID 6204740731, 235 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Premier Home Health LLC Home health agency, Newark, OH, CCN 369198
• Centerwell Home Health II Home health agency, Mount Vernon, OH, CCN 368015
• Generation Home Health LLC Home health agency, Westerville, OH, CCN 369049
• Licking Memorial Hospital Hospital, Newark, OH, CCN 360218

Merit-based Incentive Payment System (MIPS)

Final score

85.98 of 100Reported as group

Quality

75.66

Promoting interoperability

100

Improvement activities

40

Cost

75.38

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: spathmanathan@lickingmemorial.medicity.net

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.

• Licking Memorial Health Professionals

  • Family Medicine Physician
  • Newark, OH
  • NPI 1326072265
  Medicare reassignment Care Compare group NPD
• Fairview Clinics

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218
  Medicare reassignment NPD
• Licking Memorial Hospital

  • General Acute Care Hospital
  • Newark, OH
  • NPI 1568446755
  NPD
• Licking Memorial Professional Corporation

  • Durable Medical Equipment & Medical Supplies
  • Newark, OH
  • NPI 1326436510
  NPD
• Licking Memorial Professional Corporation

  • Anatomic Pathology & Clinical Pathology Physician
  • Newark, OH
  • NPI 1932186053
  NPD
• Fairview Clinics

  • Primary Care Clinic/Center
  • Saint Paul, MN
  • NPI 1396552147
  NPD
• Fairview Clinics

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1447442132
  NPD
• Licking Memorial Professional Corp.

  • Surgery Physician
  • Newark, OH
  • NPI 1366461386
  NPD (past)
• Licking Memorial Professional Corp.

  • Pediatrics Physician
  • Utica, OH
  • NPI 1497771521
  NPD (past)

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

• Generation Home Health LLC

  • Home Health Agency
  • Newark, OH
  • NPI 1407058381
  Care Compare affiliation
• Licking Memorial Hospital

  • General Acute Care Hospital
  • Newark, OH
  • NPI 1568446755
  Care Compare affiliation
• PF Development 15, LLC

  • Home Health Agency
  • Mount Vernon, OH
  • NPI 1821398447
  Care Compare affiliation
• Premier Home Health,LLC

  • Home Health Agency
  • Newark, OH
  • NPI 1164922191
  Care Compare affiliation

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685059200000",
    "number": "1205191871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 MCMILLEN DR",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551809",
            "telephone_number": "220-564-4805",
            "fax_number": "220-564-4811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MCMILLEN DR",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551809",
            "telephone_number": "220-564-4805",
            "fax_number": "220-564-4811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATHMANATHAN",
        "first_name": "SUBA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-10",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "66234",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301100221",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.141212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spathmanathan24956@lickingmemorial.medicity.net",
            "affiliation": "N",
            "address_1": "120 McMillen Dr",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430551809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kush Patel
• Minesh A Patel, DDS
• Priyanshi Patel, MD
• Shantilal Patel, MD
• Kevin Patellos, PHARMD
• Pathways of Licking County
• Walter Patrick
• Cassandra Patterson
• Stacey Patterson Sr.
• Sherry Peck

• Internal Medicine Physician in Newark, OH
• Providers in Newark, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.