NPIMap

Individual provider Active NPI

Achuta Kumar Guddati, MD

  • Hematology & Oncology Physician
  • Stony Brook, NY
National Provider Identifier
1457639312
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
315533 Issued in NY
Practice address
100 Nicolls Rd # T15053
Stony Brook, NY 11794-0002
Phone
(631) 444-3655
NPI assigned
Jul 26, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 080307 GA
Hematology & Oncology Physician 207RH0003X 315533 NY Primary

Addresses

Primary practice location

100 Nicolls Rd # T15053
Stony Brook, NY 11794-0002

Mailing address

100 Nicolls Rd # T15-053
Stony Brook, NY 11794-0001
Phone (631) 444-3655

Other practice location 1

450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (312) 404-8928

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, KY, NC, NY4 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20180809004812 GA Practitioner - Hematology/Oncology 2860664307 Reassigns benefits to 1 organization
I20191212002459 KY Practitioner - Hematology/Oncology 2860664307 Reassigns benefits to 1 organization
I20220627002632 NC Practitioner - Hematology/Oncology 2860664307
I20220629000498 NY Practitioner - Hematology/Oncology 2860664307 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians
Stony Brook Internists University Faculty Practice CorporationGroup PAC ID 9133019821, shared by 4 NPIs, 427 clinicians

Practice addresses (Care Compare)

1 Trillium Way
Corbin, KY 40701-8420
Phone (606) 523-1934

100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1750

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-0580

26 Research Way
East Setauket, NY 11733-3526
Phone (631) 444-0580

3 Edmond D Pellegrino Rd
Stony Brook, NY 11794-9447
Phone (631) 638-1000

317 S Manning Blvd
Suite 220
Albany, NY 12208-3909
Phone (518) 525-6418

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
315533NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Associates Inc CurrentSince Jul 1, 2018 Accepting new patients
St. Peter'S Hospital of the City of Albany Internal Medicine CurrentSince May 1, 2022 Accepting new patients
St. Peter'S Hospital of the City of Albany Internal Medicine CurrentSince May 1, 2022 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Current Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Sep 6, 2023 Accepting new patients
Au Medical Associates Inc CurrentSince Jul 1, 2018 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Sep 6, 2023 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Sep 6, 2023 Accepting new patients
Samaritan Hospital of Troy, New York Internal Medicine CurrentSince May 1, 2022 Accepting new patients
LGH Professional Services LLC Internal Medicine Past Accepting new patients
University Hospital at Stony Brook Past Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

1499 Walton Way
Ste 1400
Augusta, GA 30901
Phone (706) 721-4951

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

317 S Manning Blvd
Ste 220
Albany, NY 12208
Phone (518) 525-6418

26 Research Way
East Setauket, NY 11733
Phone (631) 444-0502

3 Edmund D Pellegrino Rd
Stony Brook, NY 11794
Phone (631) 638-0800

100 Nicolls Rd
#T15053
Stony Brook, NY 11794
Phone (631) 444-3655

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

1300 Massachusetts Ave
Troy, NY 12180
Phone (518) 268-5000

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: aguddati1838567@direct.trinity-health.org

Organizations & group practices 12

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 11

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": "1311638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1457639312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NICOLLS RD # T15-053",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-3655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NICOLLS RD # T15053",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940002",
            "telephone_number": "631-444-3655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Clarkson Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112032012",
            "country_code": "US",
            "telephone_number": "312-404-8928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUDDATI",
        "first_name": "ACHUTA",
        "middle_name": "KUMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-26",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "GA",
            "license": "080307",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "315533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.