Individual provider Active NPI

Latha Subramaniam, M.D.

  • Cardiovascular Disease Physician
  • Danbury, CT
National Provider Identifier
1366736258
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
72463 Issued in CT
Practice address
111 Osborne St
Danbury, CT 06810-6000
Phone
(203) 739-7155
NPI assigned
Jun 8, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 282318 NY
Student in an Organized Health Care Education/Training Program 390200000X 4301098711 MI
Cardiovascular Disease Physician 207RC0000X 72463 CT Primary

Addresses

Primary practice location

111 Osborne St
Danbury, CT 06810-6000

Mailing address

1 Kennedy Ave Unit 4006
Danbury, CT 06810-5897
Phone (609) 851-6709

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171114000440 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8224394929 Reassigns benefits to 1 organization
I20221111000849 CT Practitioner - Cardiovascular Disease (Cardiology) 8224394929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Ohio State University College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nuvance Health Medical Practice CT IncGroup PAC ID 4789597691, 742 clinicians

Practice addresses (Care Compare)

111 Osborne St
Suite 121
Danbury, CT 06810-6019
Phone (203) 739-7038

Hospital & facility affiliations

  • Danbury Hospital Hospital, Danbury, CT, CCN 070033
  • Griffin Hospital Hospital, Derby, CT, CCN 070031
  • Putnam Hospital Center Hospital, Carmel, NY, CCN 330273

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72463CTMDCardiovascular Disease Physician
282318NYMDCardiovascular Disease Physician
4301098711MIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
New York Queens Medicine and Surgery, P.C. CurrentSince Sep 17, 2017 Accepting new patients
New York Queens Medicine and Surgery, P.C. CurrentSince Sep 17, 2017 Accepting new patients
Nuvance Health Medical Practice CT, Inc. Cardiovascular Disease CurrentSince Nov 28, 2022 Accepting new patients

Locations

111 Osborne St
Danbury, CT 06810
Phone (203) 739-7131

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

111 Osborne St
Ste 121
Danbury, CT 06810
Phone (203) 739-7010

16303 Horace Harding Expy
Fl 2
Fresh Meadows, NY 11365
Phone (718) 888-9121

1981 Marcus Ave
Ste 208
North New Hyde Park, NY 11042
Phone (718) 670-1415

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.

Hospital & facility affiliations 4

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": "1307491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1366736258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KENNEDY AVE UNIT 4006",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105897",
            "telephone_number": "609-851-6709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 OSBORNE ST",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106000",
            "telephone_number": "203-739-7155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUBRAMANIAM",
        "first_name": "LATHA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-08",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "282318",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301098711",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CT",
            "license": "72463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.