Individual provider Active NPI

Siva Kumar Muddana

  • Internal Medicine Physician
  • Mount Vernon, NY
National Provider Identifier
1306246335
Registry record updated Aug 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD2017-0645 Issued in NM
Practice address
12 N 7TH Ave
Montefiore Mount Vernon Hospital
Mount Vernon, NY 10550-2026
Phone
(914) 361-8000
NPI assigned
Aug 27, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2017

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 MD2017-0645 NM Primary

Addresses

Primary practice location

12 N 7TH Ave
Montefiore Mount Vernon Hospital
Mount Vernon, NY 10550-2026

Mailing address

PO Box 26666
PHS Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-6770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20170911000360 NM Practitioner - Internal Medicine 4688947849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

8300 Constitution Ave NE
Albuquerque, NM 87110-7613
Phone (505) 291-2700

Hospital & facility affiliations

  • Presbyterian Hospital Hospital, Albuquerque, NM, CCN 320021

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Internal Medicine CurrentSince Aug 7, 2017 Accepting new patients
Presbyterian Healthcare Services Internal Medicine CurrentSince Aug 7, 2017 Accepting new patients

Locations

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

8300 Constitution Ave NE
Albuquerque, NM 87110
Phone (505) 291-2000

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

Interoperability endpoints

  • Direct secure messaging: smuddana110297@direct.phs.org

Organizations & group practices 2

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 2

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": "1409097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502668800000",
    "number": "1306246335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PHS PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-6770",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 N 7TH AVE",
            "address_2": "MONTEFIORE MOUNT VERNON HOSPITAL",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502026",
            "telephone_number": "914-361-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDDANA",
        "first_name": "SIVA KUMAR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-27",
        "last_updated": "2017-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD2017-0645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, NY

Sources for this page

Verify at the official NPI Registry.