Individual provider Active NPI

Sasidhar Gunturu, MD

  • Psychosomatic Medicine Physician
  • Bronx, NY
National Provider Identifier
1730443870
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychosomatic Medicine PhysicianTaxonomy code 2084P0015X
License
287838 Issued in NY
Practice address
57-69 West Burnside Avenue
Bronx, NY 10453-4038
Phone
(718) 839-8900
Fax
(718) 299-4030
NPI assigned
Jul 3, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychosomatic Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0015X 287838 NY Primary

Addresses

Primary practice location

57-69 West Burnside Avenue
Bronx, NY 10453-4038

Mailing address

85 W Burnside Ave
Bronx, NY 10453-4015
Phone (718) 483-1270

Other practice location 1

1276 Fulton Ave
Bronx, NY 10456-3402
Phone (718) 901-8653

Other practice location 2

57 W Burnside Ave # 69
Bronx, NY 10453-4038
Phone (718) 839-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20170921000816 NY Practitioner - Psychiatry 2163792854 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronxcare Health SystemGroup PAC ID 3870404429, 335 clinicians

Practice addresses (Care Compare)

1276 Fulton Ave
Bronx, NY 10456-3402
Phone (718) 992-7669

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Morris Heights Health Center, Inc. Single Specialty CurrentSince Jul 17, 2017 Accepting new patients
Bronxcare Health System CurrentSince Nov 4, 2017 Accepting new patients
Bronxcare Health System Single Specialty CurrentSince Nov 4, 2017 Accepting new patients
Morris Heights Health Center, Inc. CurrentSince Jul 17, 2017 Accepting new patients
Morris Heights Health Center, Inc. Past Accepting new patients

Locations

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

85 W Burnside Ave
Bronx, NY 10453
Phone (718) 483-1270

1276 Fulton Ave
Bronx, NY 10456
Phone (718) 518-5000

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: sasidhar.gunturu.p1@direct.mhhc.nextgenshare.com

Organizations & group practices 5

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 1

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": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1730443870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 W BURNSIDE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534015",
            "telephone_number": "718-483-1270",
            "fax_number": "718-299-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57-69 WEST BURNSIDE AVENUE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534038",
            "telephone_number": "718-839-8900",
            "fax_number": "718-299-4030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1276 Fulton Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104563402",
            "country_code": "US",
            "telephone_number": "718-901-8653",
            "fax_number": "718-901-8656",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "57 W Burnside Ave # 69",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104534038",
            "country_code": "US",
            "telephone_number": "718-839-8900",
            "fax_number": "718-299-4030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUNTURU",
        "first_name": "SASIDHAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0015X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "NY",
            "license": "287838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.