Progressive Critical Care Medicine, LLC

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

Legal business name

PROGRESSIVE CRITICAL CARE MEDICINE, LLC

Practice address

4320 Seminary Rd
Alexandria, VA 22304-1535

Phone

(703) 504-3000

NPI assigned

Dec 15, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Subodhkumar Sundaram, MDNPI 1447201751

Title

Physician

Phone

(703) 996-9964

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

Enrollment records 2

Locations

Practitioners 1

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

• Subodhkumar Sundaram, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Washington, DC
  • NPI 1447201751

  VA

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1481760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481760000000",
    "number": "1679017255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4019 WOODLAND RD",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220032606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 SEMINARY RD",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041535",
            "telephone_number": "703-504-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE CRITICAL CARE MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-15",
        "last_updated": "2016-12-15",
        "status": "A",
        "authorized_official_last_name": "SUNDARAM",
        "authorized_official_first_name": "SUBODHKUMAR",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "703-996-9964",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Critical Care Medicine (Internal Medicine) Physician in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Critical Care Medicine (Internal Medicine) Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.