Sneha Subbarayan

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

73397 Issued in WI

Practice address

640 Deerwood Ave
Neenah, WI 54956-7110

Phone

(920) 727-9982

Fax

(920) 727-9983

NPI assigned

Apr 3, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ssubbarayan296376@direct.thedacare.org

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.

• Thedacare, Incorporated

  • Family Medicine Physician
  • New London, WI
  • NPI 1376656959
  Medicare reassignment NPD
• Thedacare, Incorporated

  • Counselor
  • Menasha, WI
  • NPI 1306959515
  NPD
• Thedacare Medical Center - Berlin, Inc.

  • Critical Access Hospital
  • Berlin, WI
  • NPI 1760413777
  NPD (past)

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1467847715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-727-9982",
            "fax_number": "920-727-9983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 DEERWOOD AVE",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549567110",
            "telephone_number": "920-727-9982",
            "fax_number": "920-727-9983"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 Gillham Rd",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "64108",
            "country_code": "US",
            "telephone_number": "816-234-3000",
            "fax_number": "816-302-9939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUBBARAYAN",
        "first_name": "SNEHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-03",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2018015283",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "73397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Maria Adell Stumo, PA-C
• Hasan Faisal Sultan
• Jane Helene Suprise, CPNT
• Surgery Center of the Fox Valley LLC
• Surgical Associates of Neenah, S.C.
• Surgical Associates of the Fox Cities SC

• Pediatrics Physician in Neenah, WI
• Providers in Neenah, WI by specialty
• Pediatrics Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.