NPIMap

Individual provider Active NPI

Sushma Medikayala, M.D

  • Nephrology Physician
  • Mount Rainier, MD
National Provider Identifier
1518227396
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
2014-01606 Issued in NC
Practice address
4608 29TH St
Apt 2
Mount Rainier, MD 20712-1312
Phone
(914) 413-1496
NPI assigned
May 25, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2014-01606 NC
Nephrology Physician 207RN0300X 2014-01606 NC Primary

Addresses

Primary practice location

4608 29TH St
Apt 2
Mount Rainier, MD 20712-1312

Mailing address

4608 29TH St
Apt 2
Mount Rainier, MD 20712-1312
Phone (914) 413-1496

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smedikayala264589@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20140930000262 NC Practitioner - NephrologyPractitioner - Internal Medicine 7810117629 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Nephrology Associates PLLCGroup PAC ID 2264420512, 75 clinicians

Practice addresses (Care Compare)

2400 Wayne Memorial Dr
Suite E
Goldsboro, NC 27534-1750
Phone (252) 823-8513

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Unc Physicians Network LLC Current Accepting new patients
Unc Physicians Network LLC Internal Medicine CurrentSince Jul 18, 2022 Accepting new patients
Eastern Nephrology Associates PLLC Nephrology CurrentSince Sep 6, 2023 Accepting new patients
University of North Carolina at Chapel Hill Internal Medicine CurrentSince Jul 5, 2022 Accepting new patients

Locations

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123

100 Eastowne Dr
Fl 14
Chapel Hill, NC 27514
Phone (984) 215-5556

100 Eastowne Dr
Fl 56
Chapel Hill, NC 27514
Phone (984) 215-5556

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

1021 Beaman St
Clinton, NC 28328
Phone (910) 590-3569

2400 Wayne Memorial Dr
Ste E
Goldsboro, NC 27534
Phone (919) 580-9840

2809 McLamb Pl
Goldsboro, NC 27534
Phone (919) 580-9840

511 Paladin Dr
Greenville, NC 27834
Phone (252) 317-2280

300 W 27th St
Lumberton, NC 28358
Phone (910) 671-5000

5221 Paramount Pkwy
Ste 220
Morrisville, NC 27560
Phone (984) 215-4110

2460 Curtis Ellis Dr
Rocky Mount, NC 27804
Phone (252) 443-8199

1135 Carthage St
Sanford, NC 27330
Phone (910) 774-2100

1139 Carthage St
Ste 105
Sanford, NC 27330
Phone (919) 774-2875

Interoperability endpoints

  • Direct secure messaging: smedikayala264589@direct.unc.nchie.net
  • Direct secure messaging: smedikayala55620@direct.acumenmd.com

Organizations & group practices 5

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": "1337904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1518227396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4608 29TH ST",
            "address_2": "APT 2",
            "city": "MOUNT RAINIER",
            "state": "MD",
            "postal_code": "207121312",
            "telephone_number": "914-413-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4608 29TH ST",
            "address_2": "APT 2",
            "city": "MOUNT RAINIER",
            "state": "MD",
            "postal_code": "207121312",
            "telephone_number": "914-413-1496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDIKAYALA",
        "first_name": "SUSHMA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-25",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2014-01606",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NC",
            "license": "2014-01606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smedikayala264589@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "101 Manning Dr",
            "city": "Chapel Hill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275144220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Rainier, MD

Sources for this page

Verify at the official NPI Registry.