Individual provider Active NPI

Kumara Sidhartha, MD

  • Internal Medicine Physician
  • South Yarmouth, MA
National Provider Identifier
1629091608
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
215838 Issued in MA
Practice address
495 Station Ave
South Yarmouth, MA 02664-1218
Phone
(508) 778-4777
Fax
(508) 771-9555
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 215838 MA Primary

Addresses

Primary practice location

495 Station Ave
South Yarmouth, MA 02664-1218

Mailing address

297 North St Ste 221
Hyannis, MA 02601-5133
Phone (508) 862-7777

Other identifiers 7

IdentifierTypeStateIssuer
043369730OtherPRIVATE HEALTHCARE SYSTEM
694622OtherHARVARD PILGRIM
J25418OtherBLUE CROSS
043369730OtherFIRST HEALTH
7390460OtherAETNA
0183610MedicaidMA
215838OtherTUFTS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20110511000199 MA Practitioner - Internal Medicine 4284810136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

495 Station Ave
S Yarmouth, MA 02664-1218
Phone (774) 552-3208

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.23 of 100Reported as group
Quality
56.78
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Affiliates of Cape Cod, Inc. CurrentSince Aug 1, 2021 Accepting new patients
Medical Affiliates of Cape Cod, Inc. Internal Medicine CurrentSince Aug 1, 2021 Accepting new patients

Locations

27 Park St
Hyannis, MA 02601
Phone (508) 775-5011

297 North St
Ste 221
Hyannis, MA 02601
Phone (508) 862-5032

433 W Main St
Hyannis, MA 02601
Phone (508) 362-0099

130 North St
Hyannis, MA 02601
Phone (508) 775-8282

1030 Falmouth Rd
Hyannis, MA 02601
Phone (774) 470-5080

495 Station Ave
South Yarmouth, MA 02664
Phone (508) 957-7400

Organizations & group practices 2

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 2

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1629091608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 NORTH ST STE 221",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026015133",
            "telephone_number": "508-862-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 STATION AVE",
            "city": "SOUTH YARMOUTH",
            "state": "MA",
            "postal_code": "026641218",
            "telephone_number": "508-778-4777",
            "fax_number": "508-771-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDHARTHA",
        "first_name": "KUMARA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "215838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEM",
            "identifier": "043369730",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "694622",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "J25418",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "043369730",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7390460",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0183610",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "215838",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Yarmouth, MA

Sources for this page

Verify at the official NPI Registry.