Thorsten Sundberg, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

D0072002 Issued in MD

Practice address

1221 Mercantile LN
Kaiser Permanente Largo Medical Center
Largo, MD 20774-5374

Phone

(301) 618-5500

NPI assigned

Feb 7, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in VA, DC, MD3 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 3

Specialty

Diagnostic Radiology

Education

Duke University School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, shared by 17 NPIs, 1,921 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tsundberg651048@direct.umm.edu

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.

• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Halethorpe, MD
  • NPI 1043378656

  Diagnostic Radiology

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Annapolis, MD
  • NPI 1952461816

  DC, Diagnostic Radiology

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Lansdowne, VA
  • NPI 1861552721

  Diagnostic Radiology

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Halethorpe, MD
  • NPI 1417294984
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Gaithersburg, MD
  • NPI 1831471713
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1417097684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 E JEFFERSON ST",
            "address_2": "KAISER PERMANENTE MEDICAL ENROLLMENT",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524908",
            "telephone_number": "301-816-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 MERCANTILE LN",
            "address_2": "KAISER PERMANENTE LARGO MEDICAL CENTER",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745374",
            "telephone_number": "301-618-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDBERG",
        "first_name": "THORSTEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101249287",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "DC",
            "license": "MD039193",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D0072002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2400 Mount Zion Pkwy",
            "city": "Jonesboro",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302362500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "c-cda",
            "address_1": "1221 Mercantile Ln",
            "address_2": "Kaiser Permanente Largo Medical Center",
            "city": "Largo",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207745374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David Stoner
• Tara Lynn Stoudt, DNP, NNP-BC
• Anuj Subedi, MBBS
• Ashasha Tselat Sumbatyan, PTA
• Summit Ambulatory Surgical Center LLC
• Sunny Day ABA LLC
• Donna Alicia Surratt, MSW
• Susan E Jenkins, M.D.P.a.
• Quintin Talley, LCPC
• Brownhilda E Tanyi, NP

• Diagnostic Radiology Physician in Largo, MD
• Providers in Largo, MD by specialty
• Diagnostic Radiology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; 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.