NPIMap

Individual provider Active NPI

Amulya T Siram, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Dover, NH
National Provider Identifier
1447424817
Registry record updated Feb 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
14903 Issued in NH
Practice address
10 Members Way
Suite 400
Dover, NH 03820-5933
Phone
(603) 742-1143
Fax
(603) 749-3509
NPI assigned
Apr 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 14903 NH Primary

Addresses

Primary practice location

10 Members Way
Suite 400
Dover, NH 03820-5933

Mailing address

789 Central Ave
Dover, NH 03820-2526
Phone (603) 742-1143

Other identifiers 2

IdentifierTypeStateIssuer
3076445MedicaidNH
1447424817MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101117000985 NH Practitioner - Endocrinology 7810182789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Boston University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wentworth Douglass Physician CorporationGroup PAC ID 5496749848, 429 clinicians

Practice addresses (Care Compare)

10 Members Way
400 Endocrinology and Diabetes
Dover, NH 03820-5933
Phone (603) 742-1143

Hospital & facility affiliations

  • Wentworth-Douglass Hospital Hospital, Dover, NH, CCN 300018
  • York Hospital Hospital, York, ME, CCN 200020
  • Portsmouth Regional Hospital Hospital, Portsmouth, NH, CCN 300029
  • Huggins Hospital Hospital, Wolfeboro, NH, CCN 301312

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14903NHMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wentworth Douglass Physician Corporation CurrentSince Sep 28, 2010 Accepting new patients
Wentworth Douglass Hospital Current Accepting new patients
Wentworth Douglass Physician Corporation Endocrinology, Diabetes & Metabolism CurrentSince Sep 28, 2010 Accepting new patients
Westchester Neurological Consultant PC Past Accepting new patients

Locations

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

10 Members Way
Ste 400
Dover, NH 03820
Phone (603) 740-2887

750 Central Ave
Ste Q
Dover, NH 03820
Phone (603) 742-6030

Interoperability endpoints

  • Direct secure messaging: siram.amulya.wdh@direct.partners.masshiway.net
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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 7

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": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392595200000",
    "number": "1447424817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "789 CENTRAL AVE",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202526",
            "telephone_number": "603-742-1143",
            "fax_number": "603-749-3509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MEMBERS WAY",
            "address_2": "SUITE 400",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038205933",
            "telephone_number": "603-742-1143",
            "fax_number": "603-749-3509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRAM",
        "first_name": "AMULYA",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-16",
        "last_updated": "2014-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NH",
            "license": "14903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3076445",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447424817",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.