Individual provider Active NPI

Sowmini Medavaram, MD

  • Hematology & Oncology Physician
  • Martinsburg, WV
National Provider Identifier
1255775987
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
29028 Issued in WV
Practice address
2000 Foundation Way Ste 2600
Martinsburg, WV 25401-9197
Phone
(304) 267-1944
NPI assigned
Apr 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Hematology & Oncology Physician 207RH0003X 29028 WV Primary

Addresses

Primary practice location

2000 Foundation Way Ste 2600
Martinsburg, WV 25401-9197

Mailing address

2500 Foundation Way
Martinsburg, WV 25401-9000
Phone (304) 264-9202

Other practice location 1

201 Lyons Ave
Newark, NJ 07112-2027
Phone (732) 540-3579

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address smedavaram142522@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address smedavaram142522@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190723002329 WV Practitioner - Hematology/Oncology 3577824333 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2000 Foundation Way
Suite 2600
Martinsburg, WV 25401-9197
Phone (304) 267-1944

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince Jan 1, 2023 Accepting new patients
West Virginia University Medical Corporation CurrentSince Jan 1, 2023 Accepting new patients
University Healthcare Physicians, Inc. Hematology & Oncology CurrentSince Jul 24, 2019 Accepting new patients
University Healthcare Physicians Inc CurrentSince Jul 24, 2019 Accepting new patients

Locations

2000 Foundation Way
Ste 3100
Martinsburg, WV 25401
Phone (304) 260-1436

2500 Foundation Way
Martinsburg, WV 25401
Phone (304) 264-9202

2000 Foundation Way
Ste 2600
Martinsburg, WV 25401
Phone (304) 263-7023

2000 Foundation Way
Martinsburg, WV 25401
Phone (304) 260-1436

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

Organizations & group practices 4

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 6

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": "1366761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1255775987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 FOUNDATION WAY",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254019000",
            "telephone_number": "304-264-9202",
            "fax_number": "304-294-9042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 FOUNDATION WAY STE 2600",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254019197",
            "telephone_number": "304-267-1944"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Lyons Ave",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071122027",
            "country_code": "US",
            "telephone_number": "732-540-3579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDAVARAM",
        "first_name": "SOWMINI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-24",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "WV",
            "license": "29028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smedavaram142522@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2000 Foundation Way",
            "city": "Martinsburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "254019003",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smedavaram142522@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2000 Foundation Way Ste 2600",
            "city": "Martinsburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "254019197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

Verify at the official NPI Registry.