Individual provider Active NPI

Sujatha Hari Subramanian, M.D.

  • Family Medicine Physician
  • Plano, TX
National Provider Identifier
1619088275
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M0285 Issued in TX
Practice address
4670 McDermott Rd Ste 202
Plano, TX 75024-7794
Phone
(972) 943-0736
Fax
(972) 943-7921
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M0585 TX
Family Medicine Physician 207Q00000X M0285 TX Primary

Addresses

Primary practice location

4670 McDermott Rd Ste 202
Plano, TX 75024-7794

Mailing address

4670 McDermott Rd Ste 202
Plano, TX 75024-7794
Phone (972) 943-0736

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050110000684 TX Practitioner - Family Practice 2062460769 Practice locations: Plano, TX

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4670 McDermott Rd
Suite 202
Plano, TX 75024-7790

4670 McDermott Rd
Suite 202
Plano, TX 75024-7794
Phone (972) 943-0736

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M0585TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shiva Medical Care Center LLC PastSince Mar 12, 2024 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IICEAA/Endpoint/IICEAA

Organizations & group practices 1

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 1

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1619088275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4670 MCDERMOTT RD STE 202",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750247794",
            "telephone_number": "972-943-0736",
            "fax_number": "972-943-7921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4670 MCDERMOTT RD STE 202",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750247794",
            "telephone_number": "972-943-0736",
            "fax_number": "972-943-7921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUBRAMANIAN",
        "first_name": "SUJATHA",
        "middle_name": "HARI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M0585",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M0285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.