NPIMap

Individual provider Active NPI

Sushma Gaddam

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1851773139
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
290570 Issued in NY
Practice address
550 1St Ave
New York, NY 10016-6402
Phone
(212) 263-3813
NPI assigned
Jun 23, 2015
Last updated
Jun 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 290570 NY Primary

Addresses

Primary practice location

550 1St Ave
New York, NY 10016-6402

Mailing address

550 1St Ave
New York, NY 10016-6402

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sgaddam128912@nyumc.direct-ci.com Other NYU Langone

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20210304002121 NY Practitioner - Diagnostic Radiology 0941599492 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
New York Medical College, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-3407
Phone (631) 638-2121

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-5400

201 Manor PL
Greenport, NY 11944-1222
Phone (631) 477-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince May 1, 2021 Accepting new patients
New York University CurrentSince May 1, 2021 Accepting new patients
Stony Brook Radiology, University Faculty Practice Corporation Diagnostic Radiology CurrentSince Dec 1, 2023 Accepting new patients

Locations

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Organizations & group practices 3

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 7

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": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1851773139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-3813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADDAM",
        "first_name": "SUSHMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-23",
        "last_updated": "2023-06-27",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "290570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgaddam128912@nyumc.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "NYU Langone",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Other",
            "address_1": "550 1st Ave",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100166402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.