Active NPI
Nedunchezian Sithian, M.D.
- Surgery Physician
- Staten Island, NY
National Provider Identifier
1619954997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 125292
- Practice address
- 1130 Victory Blvd
Staten Island, NY 10301-3623 - Phone
- (718) 448-5400
- Fax
- (718) 720-4989
- NPI assigned
- Dec 28, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 125292 | NY | Primary |
Addresses
Primary practice location
1130 Victory Blvd
Staten Island, NY 10301-3623
Mailing address
1130 Victory Blvd
Staten Island, NY 10301-3623
Phone (718) 448-5400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00302176 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richmond University Medical Center | Past | Accepting new patients |
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.
-
- Multi-Specialty Clinic/Center
- Staten Island, NY
- NPI 1811054042
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208908800000",
"number": "1619954997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1130 VICTORY BLVD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103013623",
"telephone_number": "718-448-5400",
"fax_number": "718-720-4989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 VICTORY BLVD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103013623",
"telephone_number": "718-448-5400",
"fax_number": "718-720-4989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SITHIAN",
"first_name": "NEDUNCHEZIAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-28",
"last_updated": "2008-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NY",
"license": "125292",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00302176",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.