Active NPI
Sumara Imtiaz Choudhry, P.A.-C
- Physician Assistant
- Bridgeport, CT
National Provider Identifier
1730626490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 4040
- Practice address
- 267 Grant Street
Bridgeport, CT 06610-2805 - Phone
- (203) 384-4677
- Fax
- (203) 384-3135
- NPI assigned
- Jan 19, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | C0006353 | MD | |
| Physician Assistant | 363A00000X | 4040 | CT | Primary |
Addresses
Primary practice location
267 Grant Street
Bridgeport, CT 06610-2805
Mailing address
20 York Street, CB-329
New Haven, CT 06510-3220
Phone (203) 384-4677
Other practice location 1
5900 Cedar Ln
Columbia, MD 21044-3635
Phone (443) 718-4067
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180703001395 | CT | Practitioner - Physician Assistant | 8426335746 | Reassigns benefits to 9 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St. Vincents Urgent Care LLC
Practice addresses (Care Compare)
15 Armstrong Rd
Shelton, CT 06484-4706
Phone (203) 929-1109
7365 Main St
Suite 7
Stratford, CT 06614-1300
Phone (203) 696-3505
Hospital & facility affiliations
- St Vincent'S Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.42 of 100
- Quality
- 83.36
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.9
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.05 of 100
- Quality
- 83.45
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.72
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Medical Group, Inc. | Current | Accepting new patients | |
| Hartford Healthcare Medical Group Specialists LLC | Current | Accepting new patients | |
| St. Vincents Urgent Care LLC | Current | Accepting new patients | |
| Hartford Healthcare Medical Group Specialists, PLLC | Current | Accepting new patients | |
| Northeast Medical Group, Inc | Current | Accepting new patients |
Locations
2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366
267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170
1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579
95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388
7365 Main St
Ste 7
Stratford, CT 06614
Phone (203) 696-3505
64 Robbins St
Waterbury, CT 06708
Phone (203) 573-7142
Interoperability endpoints
- sumara.choudhry@xdr.hhchealthdirect.org
Organizations & group practices 12
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.
-
- Surgery Physician
- Hartford, CT
- NPI 1023584216
CT
-
- Customized Equipment (DME)
- Groton, CT
- NPI 1295367068
-
- Cardiovascular Disease Physician
- Fairfield, CT
- NPI 1366745267
-
- Internal Medicine Physician
- Trumbull, CT
- NPI 1043852569
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": "1484784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631577600000",
"number": "1730626490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 YORK STREET, CB-329",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065103220",
"telephone_number": "203-384-4677",
"fax_number": "203-384-3135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "267 GRANT STREET",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066102805",
"telephone_number": "203-384-4677",
"fax_number": "203-384-3135"
}
],
"practiceLocations": [
{
"address_1": "5900 Cedar Ln",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "MD",
"postal_code": "210443635",
"country_code": "US",
"telephone_number": "443-718-4067",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHOUDHRY",
"first_name": "SUMARA",
"middle_name": "IMTIAZ",
"credential": "P.A.-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-19",
"last_updated": "2021-09-14",
"certification_date": "2021-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MD",
"license": "C0006353",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CT",
"license": "4040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.