Sourya Ranjan Mahapatra, M.D.

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

12394 Issued in NH

Practice address

Nashua Center for Healthy Aging
280 Main St., #210a
Nashua, NH 03060

Phone

(603) 577-3080

NPI assigned

Oct 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cmcnh@gohnh.allscriptsdirect.net

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.

• Catholic Medical Center

  • General Acute Care Hospital
  • Manchester, NH
  • NPI 1427154335
  Medicare reassignment NPD
• Vantage Healthcare LLC

  dba Vantage Healthcare

  • Internal Medicine Physician
  • Canton, MA
  • NPI 1366903551

  NH

  Medicare reassignment NPD
• Catholic Medical Center

  dba Manchester Anesthesia Associates

  • Anesthesiology Physician
  • Manchester, NH
  • NPI 1003692112
  NPD
• Foundation Medical Partners Inc.

  • Durable Medical Equipment & Medical Supplies
  • Amherst, NH
  • NPI 1679921472
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1457448086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 MAIN ST STE 210A",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030602920",
            "telephone_number": "603-577-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NASHUA CENTER FOR HEALTHY AGING",
            "address_2": "280 MAIN ST., #210A",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "03060",
            "telephone_number": "603-577-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAPATRA",
        "first_name": "SOURYA",
        "middle_name": "RANJAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NH",
            "license": "12394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30204441",
            "state": "NH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmcnh@gohnh.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 McGregor St",
            "city": "Manchester",
            "state": "NH",
            "country_code": "US",
            "postal_code": "031023730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kimberly Lane Magliocchetti, N.P.
• Maureen Magro
• Eleanor L. Maguire, CPNP
• Elisabeth Maguire, LICSW
• Danielle Marie Mahan, APN
• Girija Mahendrakumar
• Mohamed Abdelkawy Ezzat Mahgoub, M.D.
• Taraneh Mahjoobi, DMD
• Shanta Mahmudi, MD
• Colleen M Mahoney, MSW

• Geriatric Medicine (Internal Medicine) Physician in Nashua, NH
• Providers in Nashua, NH by specialty
• Geriatric Medicine (Internal Medicine) Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.