Individual provider Active NPI

Jibin Swankutty, MD

  • Internal Medicine Physician
  • Binghamton, NY
National Provider Identifier
1578147385
Registry record updated Sep 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
330690 Issued in NY
Practice address
169 Riverside Dr
Binghamton, NY 13905-4246
Phone
(607) 798-5111
Fax
(607) 798-5093
NPI assigned
May 7, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 330690 NY Primary

Addresses

Primary practice location

169 Riverside Dr
Binghamton, NY 13905-4246

Mailing address

1613 Campus Dr
Vestal, NY 13850-4038
Phone (914) 588-9852

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20241218002855 NY Practitioner - Internal Medicine 8820525686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Un of California, Riverside, School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cogent Medical Care PCGroup PAC ID 7315836780, 152 clinicians

Practice addresses (Care Compare)

169 Riveride Dr
Binghamton, NY 13905-4246
Phone (607) 798-5671

Hospital & facility affiliations

  • Our Lady of Lourdes Memorial Hospital, Inc Hospital, Binghamton, NY, CCN 330011
  • United Health Services Hospitals, Inc Hospital, Binghamton, NY, CCN 330394

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
330690NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Medical Care PC Internal Medicine CurrentSince Oct 17, 2024 Accepting new patients
Our Lady of Lourdes Memorial Hospital Inc. Past Accepting new patients

Locations

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

565 Abbott Rd
Rm 8632
Buffalo, NY 14220
Phone (607) 798-5671

160 N Midland Ave
Nyack, NY 10960
Phone (845) 348-2000

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

Interoperability endpoints

  • Direct secure messaging: jswankutty215612@direct-guthrie.org

Organizations & group practices 2

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 2

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": "1620345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726358400000",
    "number": "1578147385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1613 CAMPUS DR",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138504038",
            "telephone_number": "914-588-9852",
            "fax_number": "909-475-5059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 RIVERSIDE DR",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139054246",
            "telephone_number": "607-798-5111",
            "fax_number": "607-798-5093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANKUTTY",
        "first_name": "JIBIN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-07",
        "last_updated": "2024-09-15",
        "certification_date": "2024-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "330690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

Verify at the official NPI Registry.