NPIMap

Individual provider Active NPI

Rahul Sridhar Subbarayan, M.D

  • Otolaryngology Physician
  • Appleton, WI
National Provider Identifier
1801281415
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
73398-20 Issued in WI
Practice address
444 N Westhill Blvd
Appleton, WI 54914-5715
Phone
(920) 969-1768
Fax
(920) 267-5222
NPI assigned
Mar 31, 2015
Last updated
Oct 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Otolaryngology Physician 207Y00000X 73398-20 WI Primary

Addresses

Primary practice location

444 N Westhill Blvd
Appleton, WI 54914-5715

Mailing address

119 E Bell St
Neenah, WI 54956-4993
Phone (614) 313-3149

Other practice location 1

119 E Bell St
Neenah, WI 54956-4993
Phone (614) 313-3149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200727001688 WI Practitioner - Otolaryngology 2062718711 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Ohio State University College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ear Nose and Throat Specialists of Wisconsin SCGroup PAC ID 9830086925, 28 clinicians

Practice addresses (Care Compare)

119 E Bell St
Neenah, WI 54956-4993
Phone (920) 969-1768

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ear Nose and Throat Specialists of Wisconsin, SC Current Accepting new patients
Ear Nose and Throat Specialists of Wisconsin SC Single Specialty CurrentSince Aug 1, 2020 Accepting new patients

Locations

444 N Westhill Blvd
Appleton, WI 54914
Phone (920) 750-7000

618 Memorial Dr
Chilton, WI 53014
Phone (920) 849-3800

119 E Bell St
Neenah, WI 54956

515 S Washburn St
Ste 200
Oshkosh, WI 54904

855 N Westhaven Dr
#200
Oshkosh, WI 54904

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FBBAAA

Organizations & group practices 2

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1801281415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 E BELL ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549564993",
            "telephone_number": "614-313-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 N WESTHILL BLVD",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549145715",
            "telephone_number": "920-969-1768",
            "fax_number": "920-267-5222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "119 E BELL ST",
            "address_purpose": "LOCATION",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549564993",
            "country_code": "US",
            "telephone_number": "614-313-3149",
            "fax_number": "920-267-5222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUBBARAYAN",
        "first_name": "RAHUL",
        "middle_name": "SRIDHAR",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-31",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WI",
            "license": "73398-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.