Individual provider Active NPI

Suhasini Jonnavithula, MD

  • Internal Medicine Physician
  • College Point, NY
National Provider Identifier
1790966265
Registry record updated Mar 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
198979 Issued in NY
Practice address
12216 18TH Ave
College Point, NY 11356-2202
Phone
(718) 939-1991
NPI assigned
Nov 26, 2007
Last updated
Mar 12, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 198979 NY Primary

Addresses

Primary practice location

12216 18TH Ave
College Point, NY 11356-2202

Mailing address

12216 18TH Ave
College Point, NY 11356-2202
Phone (718) 939-1991

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
I20250313000816 NY Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1759336860

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
198979NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Luzato Medical Group P.C. Internal Medicine Past Accepting new patients
Luzato Medical Group, P.C. Internal Medicine Past Accepting new patients
New York City Health and Hospitals Corporation Internal Medicine Past Accepting new patients

Networks

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205280000000",
    "number": "1790966265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12216 18TH AVE",
            "city": "COLLEGE POINT",
            "state": "NY",
            "postal_code": "113562202",
            "telephone_number": "718-939-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12216 18TH AVE",
            "city": "COLLEGE POINT",
            "state": "NY",
            "postal_code": "113562202",
            "telephone_number": "718-939-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONNAVITHULA",
        "first_name": "SUHASINI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-26",
        "last_updated": "2008-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "198979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Point, NY

Sources for this page

Verify at the official NPI Registry.