Individual provider Active NPI

Subhashini Manjula Ayloo, M.D.

  • Surgery Physician
  • Providence, RI
National Provider Identifier
1437161874
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD17356 Issued in RI
Practice address
2 Dudley St Ste 370
Providence, RI 02905-3248
Phone
(401) 228-0560
Fax
(401) 228-0636
NPI assigned
Aug 13, 2006
Last updated
Jul 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Transplant Surgery Physician 204F00000X 036107630 IL
Surgery Physician 208600000X 036-107630 IL
Surgery Physician 208600000X MD17356 RI Primary

Addresses

Primary practice location

2 Dudley St Ste 370
Providence, RI 02905-3248

Mailing address

PO Box 16149
Rumford, RI 02916-0697
Phone (401) 453-9625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20160929000900 NJ Practitioner - General Surgery 7214955210 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-107630ILMDSurgery Physician
MD17356RIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Associates of New Jersey Inc Transplant Surgery CurrentSince Jul 27, 2016 Accepting new patients
University Physician Associates of New Jersey Inc CurrentSince Jul 27, 2016 Accepting new patients

Locations

140 Bergen St
Bldg D1650
Newark, NJ 07103

30 Bergen St
Rm 1205
Newark, NJ 07107
Phone (973) 972-0037

90 Bergen St
Fl 7
Newark, NJ 07103
Phone (973) 972-5350

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

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1437161874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16149",
            "city": "RUMFORD",
            "state": "RI",
            "postal_code": "029160697",
            "telephone_number": "401-453-9625",
            "fax_number": "401-435-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 DUDLEY ST STE 370",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029053248",
            "telephone_number": "401-228-0560",
            "fax_number": "401-228-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYLOO",
        "first_name": "SUBHASHINI",
        "middle_name": "MANJULA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "IL",
            "license": "036107630",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036-107630",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "RI",
            "license": "MD17356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.