Sudharam Idupuganti, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

138851 Issued in NY

Practice address

585 Bay Ridge Pkwy
Brooklyn, NY 11209-3309

Phone

(718) 921-1001

Fax

(718) 921-1001

NPI assigned

Apr 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Psychiatry

Education

Other, 1974

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: sudharamidupuganti@mai.allscriptsdirect.net

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.

• Maimonides Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1093777492
  NPD

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317340800000",
    "number": "1790742005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 BAY RIDGE PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093309",
            "telephone_number": "718-921-1001",
            "fax_number": "718-921-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 BAY RIDGE PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093309",
            "telephone_number": "718-921-1001",
            "fax_number": "718-921-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDUPUGANTI",
        "first_name": "SUDHARAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2011-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "138851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00435676",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abidemi Rachael Idowu, MD
• Catherine Ene Idowu
• Kehinde O. Idowu, NP
• Princess Leah Idowu
• Iyad Yousef Mohammad Idries
• Ginette Idy, OTR
• Emma Idzikowski, MD
• Ie Medical PC
• Briana M Ien, LCSW
• Annabel Ieong

• Psychiatry Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; 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.

Verify at the official NPI Registry.