NPIMap

Individual provider Active NPI

Sudheer Penupolu, MD

  • Pulmonary Disease Physician
  • Danville, PA
National Provider Identifier
1578818639
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD454637 Issued in PA
Practice address
100 North Academy Avenue
Danville, PA 17822
Phone
(570) 271-6655
Fax
(570) 214-3967
NPI assigned
Jul 16, 2012
Last updated
Aug 31, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X R73194 AZ
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD454637 PA
Pulmonary Disease Physician 207RP1001X MD454637 PA Primary

Addresses

Primary practice location

100 North Academy Avenue
Danville, PA 17822

Mailing address

100 North Academy Avenue
Danville, PA 17822
Phone (570) 271-6655

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address spenupolu124542@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20150715001373 PA Practitioner - Internal Medicine 4981841095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6211

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD454637PAMDCritical Care Medicine (Internal Medicine) Physician
R73194AZMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Jul 9, 2015 Accepting new patients
Geisinger Clinic CurrentSince Jul 9, 2015 Accepting new patients
Geisinger Medical Center Past Accepting new patients
Geisinger Clinic Critical Care Medicine Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

3 Hospital Dr
Ste 206
Lewisburg, PA 17837
Phone (570) 522-9771

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1578818639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NORTH ACADEMY AVENUE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "17822",
            "telephone_number": "570-271-6655",
            "fax_number": "570-214-3967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NORTH ACADEMY AVENUE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "17822",
            "telephone_number": "570-271-6655",
            "fax_number": "570-214-3967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENUPOLU",
        "first_name": "SUDHEER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-16",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": "R73194",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "PA",
            "license": "MD454637",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PA",
            "license": "MD454637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spenupolu124542@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 North Academy Avenue",
            "city": "Danville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "17822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.