Individual provider Active NPI

Padmanabhan Premkumar, M.D.

  • Internal Medicine Physician
  • Hartford, CT
National Provider Identifier
1265750004
Registry record updated Mar 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
52847 Issued in CT
Practice address
80 Seymour St
Hartford Hospital Medicine Dept
Hartford, CT 06102-5037
Phone
(860) 972-2085
Fax
(860) 972-5057
NPI assigned
May 4, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 52847 CT Primary

Addresses

Primary practice location

80 Seymour St
Hartford Hospital Medicine Dept
Hartford, CT 06102-5037

Mailing address

80 Seymour St
Hartford Hospital Medicine Dept
Hartford, CT 06102-8000
Phone (860) 972-2085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20140711001498 CT Practitioner - Internal Medicine 6901021716 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford HospitalGroup PAC ID 2567366016, shared by 6 NPIs, 1,040 clinicians

Practice addresses (Care Compare)

80 Seymour St
Hartford, CT 06102-8000

Merit-based Incentive Payment System (MIPS)

Final score
92.63 of 100Reported as group
Quality
75.35
Promoting interoperability
100
Improvement activities
40
Cost
71.44

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52847CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Hospital Internal Medicine CurrentSince May 15, 2014 Accepting new patients
Hartford Hospital CurrentSince May 15, 2014 Accepting new patients
Hartford Hospital CurrentSince May 15, 2014 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: padmanabhan.premkumar@xdr.hhchealthdirect.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1272931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553385600000",
    "number": "1265750004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR ST",
            "address_2": "HARTFORD HOSPITAL MEDICINE DEPT",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061028000",
            "telephone_number": "860-972-2085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR ST",
            "address_2": "HARTFORD HOSPITAL MEDICINE DEPT",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061025037",
            "telephone_number": "860-972-2085",
            "fax_number": "860-972-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREMKUMAR",
        "first_name": "PADMANABHAN",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-04",
        "last_updated": "2019-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "52847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.