Active NPI
S Madhusoodanan MD PC
- Psychiatry Physician
- Far Rockaway, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 138957
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02558818 | Medicaid | NY |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatry Physician
- New Hyde Park, NY
- NPI 1518922939
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.