Individual provider Active NPI

Sandeep Kumar Annam, M.D.

  • Anesthesiology Physician
  • West Islip, NY
National Provider Identifier
1760625461
Registry record updated Jul 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
270386 Issued in NY
Practice address
1000 Montauk Hwy
West Islip, NY 11795-4927
Phone
(631) 736-4064
Fax
(631) 736-1332
NPI assigned
Apr 9, 2009
Last updated
Jul 11, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 270386 NY Primary

Addresses

Primary practice location

1000 Montauk Hwy
West Islip, NY 11795-4927

Mailing address

3 Boyle Rd
Selden, NY 11784-4000
Phone (631) 736-4064

Other identifiers 1

IdentifierTypeStateIssuer
AN-270386-6WOtherNYWORKERS COMPENSATION

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
I20140818000495 NY Practitioner - Anesthesiology 7618194580 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Long Island Anesthesiologists, PLLCGroup PAC ID 5799677902, 44 clinicians

Practice addresses (Care Compare)

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (631) 376-4444

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
270386NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Anesthesiology, PC CurrentSince Aug 1, 2024 Accepting new patients
Good Samaritan Hospital Medical Center Current Accepting new patients
Long Island Anesthesiologists, PLLC Anesthesiology CurrentSince Nov 1, 2013 Accepting new patients
Good Samaritan Hospital Medical CurrentSince Mar 28, 2020 Accepting new patients

Locations

818 Ellicott St
Buffalo, NY 14203
Phone (716) 323-2000

3095 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 896-2245

369 E Main St
Ste 18
East Islip, NY 11730
Phone (631) 277-1600

210 W Park Ave
Long Beach, NY 11561
Phone (516) 431-4800

510 Broadhollow Rd
Ste 100
Melville, NY 11747
Phone (631) 424-3600

680 Old Country Rd
Plainview, NY 11803
Phone (516) 681-8400

5650 Sunrise Hwy
Sayville, NY 11782

3 Boyle Rd
Selden, NY 11784
Phone (631) 716-6000

300 S Oyster Bay Rd
Syosset, NY 11791
Phone (516) 605-2626

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

160 Crossways Park Dr
Woodbury, NY 11797
Phone (516) 364-4200

246 Crossways Park Dr W
Woodbury, NY 11797
Phone (516) 682-8900

Organizations & group practices 4

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 2

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": "1239235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405036800000",
    "number": "1760625461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 BOYLE RD",
            "city": "SELDEN",
            "state": "NY",
            "postal_code": "117844000",
            "telephone_number": "631-736-4064",
            "fax_number": "631-736-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954927",
            "telephone_number": "631-736-4064",
            "fax_number": "631-736-1332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANNAM",
        "first_name": "SANDEEP",
        "middle_name": "KUMAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-09",
        "last_updated": "2014-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "270386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMPENSATION",
            "identifier": "AN-270386-6W",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

Verify at the official NPI Registry.