Organization Active NPI

S Madhusoodanan MD PC

  • Psychiatry Physician
  • Far Rockaway, NY
National Provider Identifier
1629069901
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
138957 Issued in NY
Legal business name
S MADHUSOODANAN MD PC
Practice address
St Johns Episcopal Hospital 327 Beach Channel Drive
Far Rockaway, NY 11691-1511
Phone
(718) 869-7000
NPI assigned
Nov 4, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Subramoniam Madhusoodanan, MD
Title
President S. Madhusoodanan MD PC
Phone
(516) 371-1804

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 138957 NY Primary

Addresses

Primary practice location

St Johns Episcopal Hospital 327 Beach Channel Drive
Far Rockaway, NY 11691-1511

Mailing address

249 Broadway
Lawrence, NY 11559-1511
Phone (516) 371-1804

Other practice location 1

West Lawrence Carecenter 1410 Seagirt Boulevard
Far Rockaway, NY 11691-1511
Phone (718) 471-7000

Other practice location 2

Haven Manor Nursing Home 1441 Gateway Boulevard
Far Rockaway, NY 11691-1511
Phone (718) 471-1500

Other practice location 3

Far Rockaway Nursing Home 1311 Virginia Street
Far Rockaway, NY 11691-1511
Phone (718) 327-2909

Other practice location 4

Horizon Care Center 6411 Beach Channel Drive
Far Rockaway, NY 11691-1511
Phone (718) 945-0700

Other practice location 5

249 Broadway
Lawrence, NY 11559-1511
Phone (516) 371-1804

Other practice location 6

Grandell Rehabilitation Center 645 West Broadway
Long Beach, NY 11561-1511
Phone (516) 889-1100

Other practice location 7

Waterview Nursing Home 119-15 27TH Avenue
Flushing, NY 11354-1511
Phone (718) 461-5000

Other identifiers 1

IdentifierTypeStateIssuer
02558818MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1629069901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 BROADWAY",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591511",
            "telephone_number": "516-371-1804",
            "fax_number": "516-371-1804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ST JOHNS EPISCOPAL HOSPITAL 327 BEACH CHANNEL DRIVE",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116911511",
            "telephone_number": "718-869-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "WEST LAWRENCE CARECENTER 1410 SEAGIRT BOULEVARD",
            "address_purpose": "LOCATION",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116911511",
            "country_code": "US",
            "telephone_number": "718-471-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "HAVEN MANOR NURSING HOME 1441 GATEWAY BOULEVARD",
            "address_purpose": "LOCATION",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116911511",
            "country_code": "US",
            "telephone_number": "718-471-1500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "FAR ROCKAWAY NURSING HOME 1311 VIRGINIA STREET",
            "address_purpose": "LOCATION",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116911511",
            "country_code": "US",
            "telephone_number": "718-327-2909",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "HORIZON CARE CENTER 6411 BEACH CHANNEL DRIVE",
            "address_purpose": "LOCATION",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116911511",
            "country_code": "US",
            "telephone_number": "718-945-0700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "249 Broadway",
            "address_purpose": "LOCATION",
            "city": "Lawrence",
            "state": "NY",
            "postal_code": "115591511",
            "country_code": "US",
            "telephone_number": "516-371-1804",
            "fax_number": "516-371-1804",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "GRANDELL REHABILITATION CENTER 645 WEST BROADWAY",
            "address_purpose": "LOCATION",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115611511",
            "country_code": "US",
            "telephone_number": "516-889-1100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "WATERVIEW NURSING HOME 119-15 27TH AVENUE",
            "address_purpose": "LOCATION",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113541511",
            "country_code": "US",
            "telephone_number": "718-461-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "S MADHUSOODANAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-04",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "MADHUSOODANAN",
        "authorized_official_first_name": "SUBRAMONIAM",
        "authorized_official_title_or_position": "PRESIDENT S. MADHUSOODANAN MD PC",
        "authorized_official_telephone_number": "516-371-1804",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "138957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02558818",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.