Sudeep Bansal, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

047284 Issued in CT

Practice address

131 New London Tpke Ste 105
Glastonbury, CT 06033

Phone

(860) 430-5599

NPI assigned

Sep 25, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Internal Medicine

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Avanta Clinic LLCGroup PAC ID 9931456894, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Masonicare Home Health and Hospice Inc Hospice, Wallingford, CT, CCN 071516

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17722/brand/1/csg/1/fhir/r4
• Direct secure messaging: sudeep.bansal.1@17722.direct.athenahealth.com

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.

• Avanta Clinic LLC

  • Internal Medicine Physician
  • Glastonbury, CT
  • NPI 1619467826
  Medicare reassignment Care Compare group NPD Authorized official

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

• Masonicare Home Health and Hospice, Inc.

  • Community Based Hospice Care Agency
  • Wallingford, CT
  • NPI 1225151822
  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1346437233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 NEW LONDON TPKE STE 105",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332246",
            "telephone_number": "860-430-5599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 NEW LONDON TPKE STE 105",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "06033",
            "telephone_number": "860-430-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANSAL",
        "first_name": "SUDEEP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-25",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "047284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucinda Maria Balsome, M.S.,R.D.
• Devon Nicholas Banda, DO
• Arjun Banerjee, MD
• Ali Banki, D.O.
• Robin J Bansal
• Christopher Michael Barclay, BCBA, NCSP
• Neal David Barkoff, M.D.
• Jillian June Barnes, FNP
• Jessica K Barr, LMT
• Renee Batignani, MA, LPC

• Internal Medicine Physician in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; 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.