NPIMap

Individual provider Active NPI

Sathiyendran Poobalasingham, MD

  • Nephrology Physician
  • Kingsport, TN
National Provider Identifier
1639210222
Registry record updated Nov 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
01059186A Issued in IN
Practice address
2002 Brookside Dr
Suite 102
Kingsport, TN 37660-4634
Phone
(423) 245-6000
NPI assigned
Feb 8, 2007
Last updated
Nov 21, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 01059186A IN Primary

Addresses

Primary practice location

2002 Brookside Dr
Suite 102
Kingsport, TN 37660-4634

Mailing address

5716 Boulia Dr
Clay, NY 13041-6922
Phone (315) 935-9318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20071121000346 TN Practitioner - Internal MedicinePractitioner - Nephrology 9436247673 Reassigns benefits to 2 organizations
I20240430003197 VA Practitioner - Nephrology 9436247673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regional Kidney Care PCGroup PAC ID 5597728527, 8 clinicians
Blount Memorial Physician Group IncGroup PAC ID 6406844174, 252 clinicians

Practice addresses (Care Compare)

2002 Brookside Dr
Suite 102
Kingsport, TN 37660-4634
Phone 4232456000211

340 Anderson Hollow Rd
Suite 100
Norton, VA 24273-1100
Phone 4232456000211

350 BMH Physicians Office BLDG
Maryville, TN 37804-5819
Phone (865) 982-5044

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42132TNMDPharmacist
01059186AINMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Kidney Care, PC CurrentSince Feb 5, 2007 Accepting new patients

Locations

1 Medical Park Blvd
Ste 100E
Bristol, TN 37620
Phone (423) 652-0158

2002 Brookside Dr
Ste 102
Kingsport, TN 37660
Phone (423) 245-6000

340 Anderson Hollow Rd
#100
Norton, VA 24273
Phone (276) 679-7805

Interoperability endpoints

  • Direct secure messaging: spoobalasingham12098@direct.acumenmd.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195603200000",
    "number": "1639210222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5716 BOULIA DR",
            "city": "CLAY",
            "state": "NY",
            "postal_code": "130416922",
            "telephone_number": "315-935-9318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 BROOKSIDE DR",
            "address_2": "SUITE 102",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604634",
            "telephone_number": "423-245-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOBALASINGHAM",
        "first_name": "SATHIYENDRAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IN",
            "license": "01059186A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.