NPIMap

Individual provider Active NPI

Chitra Balasundaram, M.D.

  • Hematology & Oncology Physician
  • Bronx, NY
National Provider Identifier
1356656839
Registry record updated Mar 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
2016037296 Issued in MO
Practice address
130 W Kingsbridge Rd
James J. Peters VA Medical Center
Bronx, NY 10468-3904
Phone
(718) 584-9000
NPI assigned
Aug 9, 2010
Last updated
Mar 15, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DONT NEED ONE NY
Hematology & Oncology Physician 207RH0003X 2016037296 MO Primary

Addresses

Primary practice location

130 W Kingsbridge Rd
James J. Peters VA Medical Center
Bronx, NY 10468-3904

Mailing address

211 Golden Larch Ter NE
Leesburg, VA 20176-4032
Phone (703) 659-5808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161202001438 MO Practitioner - Hematology/OncologyPractitioner - Internal Medicine 4789964008 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

2055 S Fremont Ave
MC Radiation Oncology
Springfield, MO 65804-2206
Phone (417) 820-2468

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DONT NEED ONENYMDInternal Medicine Physician
2016037296MOMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities Internal Medicine CurrentSince Jan 1, 2017 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Jan 1, 2017 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Jan 1, 2017 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

100 Hospital Dr
Lebanon, MO 65536
Phone (417) 533-6010

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 829-4215

2055 S Fremont Ave
Fl 2
Springfield, MO 65804
Phone (417) 820-8099

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

2055 S Fremont Ave
Springfield, MO 65804
Phone (417) 820-2468

Interoperability endpoints

  • Direct secure messaging: cbalasundaram779195@directc.mercy.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1281312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1356656839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 GOLDEN LARCH TER NE",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201764032",
            "telephone_number": "703-659-5808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W KINGSBRIDGE RD",
            "address_2": "JAMES J. PETERS VA MEDICAL CENTER",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104683904",
            "telephone_number": "718-584-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALASUNDARAM",
        "first_name": "CHITRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-09",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "DONT NEED ONE",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MO",
            "license": "2016037296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.