Individual provider Active NPI

Senthil Sambandam, MD, MBBS, MS

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Boston, MA
National Provider Identifier
1750579165
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
0101266485 Issued in VA
Practice address
1400 VFW Pkwy
Boston, MA 02132-4927
Phone
(715) 897-1720
NPI assigned
Oct 10, 2007
Last updated
Oct 29, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 52397-20 WI
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 0101266485 VA Primary

Addresses

Primary practice location

1400 VFW Pkwy
Boston, MA 02132-4927

Mailing address

13 Duvall LN
Morgantown, WV 26501-2359
Phone (158) 971-7207

Other practice location 1

2360 E Pershing Blvd
Cheyenne, WY 82001-5356
Phone (419) 322-4156

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine, Master of Science

State licenses

LicenseStateTypeSpecialty
0101266485VAMDAdult Reconstructive Orthopaedic Surgery Physician
52397-20WIMDAdult Reconstructive Orthopaedic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1750579165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 DUVALL LN",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265012359",
            "telephone_number": "158-971-7207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 VFW PKWY",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021324927",
            "telephone_number": "715-897-1720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2360 E Pershing Blvd",
            "address_purpose": "LOCATION",
            "city": "Cheyenne",
            "state": "WY",
            "postal_code": "820015356",
            "country_code": "US",
            "telephone_number": "419-322-4156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMBANDAM",
        "first_name": "SENTHIL",
        "credential": "MD, MBBS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-10",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "WI",
            "license": "52397-20",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "VA",
            "license": "0101266485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.