Individual provider Active NPI

Suneetha Morthala, M.D.

  • Rheumatology Physician
  • Columbia, SC
National Provider Identifier
1407880941
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
28893 Issued in SC
Practice address
2233 Clemson Rd
Columbia, SC 29229-8016
Phone
(803) 462-2824
Fax
(803) 386-0283
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

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 28893 SC
Rheumatology Physician 207RR0500X 28893 SC Primary

Addresses

Primary practice location

2233 Clemson Rd
Columbia, SC 29229-8016

Mailing address

4611 Hard Scrabble Rd
Suite 359
Columbia, SC 29229-8584
Phone (803) 462-2824

Other identifiers 1

IdentifierTypeStateIssuer
288931MedicaidSC

Other names 1

  • Dr. Suneetha Kolli Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20060801000368 SC Practitioner - RheumatologyPractitioner - Internal Medicine 2264445626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2233 Clemson Rd
Columbia, SC 29229-8016
Phone (803) 462-2824

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sandhills Rheumatology, LLC Rheumatology CurrentSince Dec 21, 2012 Accepting new patients
Lexington County Health Services District, Inc. Past Accepting new patients

Locations

4611 Hard Scrabble Rd
Ste 359
Columbia, SC 29229

2233 Clemson Rd
Columbia, SC 29229
Phone (803) 462-2824

Interoperability endpoints

  • Direct secure messaging: suneetha.morthala@direct.sand.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 1

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372377600000",
    "number": "1407880941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 HARD SCRABBLE RD",
            "address_2": "SUITE 359",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292298584",
            "telephone_number": "803-462-2824",
            "fax_number": "803-386-0283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 CLEMSON RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292298016",
            "telephone_number": "803-462-2824",
            "fax_number": "803-386-0283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTHALA",
        "first_name": "SUNEETHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2013-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "28893",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "SC",
            "license": "28893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288931",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUNEETHA",
            "last_name": "KOLLI",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.