NPIMap

Individual provider Active NPI

Nishanth Sukumaran, MD

  • Hematology & Oncology Physician
  • Petersburg, VA
National Provider Identifier
1538328844
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
0101254006 Issued in VA
Practice address
210 Medical Park Blvd
Suite 200
Petersburg, VA 23805-9338
Phone
(804) 431-1100
Fax
(804) 862-1094
NPI assigned
Jun 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD434764 PA
Hospitalist Physician 208M00000X MD434764 PA
Hematology & Oncology Physician 207RH0003X 0101254006 VA Primary

Addresses

Primary practice location

210 Medical Park Blvd
Suite 200
Petersburg, VA 23805-9338

Mailing address

7202 Glen Forest Dr
Suite 200
Richmond, VA 23226-3781
Phone (804) 673-2024

Other practice location 1

4730 Puddledock Rd Ste 100
Prince George, VA 23875-1274
Phone (804) 452-3850

Other practice location 2

263 Medical Park Blvd
Petersburg, VA 23805-0002
Phone (804) 431-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20130702000153 VA Practitioner - Hematology/OncologyPractitioner - Hematology 4183790157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Hematology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4730 Puddledock Rd
Suite 100
Prince George, VA 23875-1274
Phone (804) 452-3850

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.62 of 100Reported as individual
Quality
75.01
Promoting interoperability
67
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD434764PAMDInternal Medicine Physician
0101254006VAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Cancer Institute Incorporated Hematology & Oncology CurrentSince Aug 29, 2016 Accepting new patients
Virginia Cancer Institute Incorporated Hematology & Oncology CurrentSince Aug 29, 2016 Accepting new patients
S.B.Kondragunta LLC Hematology & Oncology PastSince Jul 1, 2005 Accepting new patients

Locations

7492 Right Flank Rd
Mechanicsville, VA 23116
Phone (804) 559-0736

1401 Johnston Willis Dr
Ste 100
North Chesterfield, VA 23235
Phone (804) 287-3000

210 Medical Park Blvd
Ste 200
Petersburg, VA 23805
Phone (804) 431-1100

263 Medical Park Blvd
Petersburg, VA 23805
Phone (804) 431-1100

4730 Puddledock Rd
Ste 100
Prince George, VA 23875
Phone (804) 452-3850

7202 Glen Forest Dr
Ste 200
Richmond, VA 23226
Phone (804) 673-0134

8007 Discovery Dr
Ste A
Richmond, VA 23229
Phone (804) 287-3000

Interoperability endpoints

  • FHIR API: https://fhir.prod.flatiron.io/fhir/

Organizations & group practices 3

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 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1538328844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7202 GLEN FOREST DR",
            "address_2": "SUITE 200",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232263781",
            "telephone_number": "804-673-2024",
            "fax_number": "804-673-1796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 MEDICAL PARK BLVD",
            "address_2": "SUITE 200",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059338",
            "telephone_number": "804-431-1100",
            "fax_number": "804-862-1094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4730 Puddledock Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Prince George",
            "state": "VA",
            "postal_code": "238751274",
            "country_code": "US",
            "telephone_number": "804-452-3850",
            "fax_number": "804-541-7585",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "263 Medical Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Petersburg",
            "state": "VA",
            "postal_code": "238050002",
            "country_code": "US",
            "telephone_number": "804-431-1100",
            "fax_number": "804-862-1094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUKUMARAN",
        "first_name": "NISHANTH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-03",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD434764",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD434764",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "VA",
            "license": "0101254006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, VA

Sources for this page

Verify at the official NPI Registry.