S Madhusoodanan MD PC

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

Last updated

Mar 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Subramoniam Madhusoodanan, MDNPI 1992794705

Title

President S. Madhusoodanan MD PC

Phone

(516) 371-1804

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Subramoniam Madhusoodanan, MD

  • Psychiatry Physician
  • Far Rockaway, NY
  • NPI 1992794705
  Authorized official Same address or phone
• Annupriya Itteera, MD

  • Psychiatry Physician
  • New Hyde Park, NY
  • NPI 1518922939
  NPD (past)

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": "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"
        },
        {
            "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": "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": "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": "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"
        }
    ],
    "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": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Far Rockaway, NY
• Providers in Far Rockaway, NY by specialty
• Psychiatry Physician in New York

• 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.