Individual provider Active NPI

Vasu Chirumamilla, M.D.

  • Surgery Physician
  • Suffern, NY
National Provider Identifier
1366786998
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
267016 Issued in NY
Practice address
156 Route 59 Ste A2
Suffern, NY 10901-5013
Phone
(845) 517-2870
NPI assigned
Nov 20, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 267016 NY Primary

Addresses

Primary practice location

156 Route 59 Ste A2
Suffern, NY 10901-5013

Mailing address

16 Manor CT
New City, NY 10956-2221
Phone (716) 553-2550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20210818001615 NY Practitioner - General Surgery 0648675322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri State Surgical Associates PLLCGroup PAC ID 1254330509, 4 clinicians

Practice addresses (Care Compare)

156 Route 59
Suite A2
Suffern, NY 10901-5013
Phone (845) 517-2870

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
267016NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vasu Chirumamilla MD PLLC Surgery CurrentSince Aug 4, 2024 Accepting new patients
Tri State Surgical Associates PLLC CurrentSince Sep 19, 2022 Accepting new patients
Good Samaritan Hospital of Suffern Past Accepting new patients
Recoverhealth Medical Services, PLLC Surgery Past Accepting new patients

Locations

200 Westage Business Ctr Dr
Ste 119
Fishkill, NY 12524
Phone (845) 896-0610

384 Crystal Run Rd
Ste 201
Middletown, NY 10941
Phone (845) 692-8780

156 Route 59
Ste A2
Suffern, NY 10901
Phone (845) 360-9553

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

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 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": "1353369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1366786998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 MANOR CT",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109562221",
            "telephone_number": "716-553-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 ROUTE 59 STE A2",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109015013",
            "telephone_number": "845-517-2870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIRUMAMILLA",
        "first_name": "VASU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-20",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "267016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffern, NY

Sources for this page

Verify at the official NPI Registry.