Individual provider Active NPI

Sunil K Yerragondu

  • Internal Medicine Physician
  • East Hartford, CT
National Provider Identifier
1912232646
Registry record updated Oct 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
50589 Issued in CT
Practice address
478 Burnside Ave
East Hartford, CT 06108-2425
Phone
(860) 528-7161
NPI assigned
Oct 14, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 50589 CT Primary
Specialist 174400000X 50589 CT

Addresses

Primary practice location

478 Burnside Ave
East Hartford, CT 06108-2425

Mailing address

24 Park PL
Apt 25 H
Hartford, CT 06106-5008
Phone (732) 330-4057

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20120801000209 CT Practitioner - Internal Medicine 5991961260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
M Hasan Yekta MD PCGroup PAC ID 2668463985, 5 clinicians

Practice addresses (Care Compare)

290 Collins St
Hartford, CT 06105-1549
Phone (860) 246-0500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50589CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
M. Hasan Yekta, M.D. P.C. Internal Medicine CurrentSince Jul 1, 2012 Accepting new patients
Shafa Medical Clinic PC Past Accepting new patients

Locations

478 Burnside Ave
East Hartford, CT 06108
Phone (860) 289-7161

27 Burnside Ave
East Hartford, CT 06108
Phone (860) 289-7161

290 Collins St
Hartford, CT 06105
Phone (860) 246-0500

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18519/brand/1/csg/1/fhir/r4

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 6

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": "1255478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351641600000",
    "number": "1912232646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 PARK PL",
            "address_2": "APT 25 H",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061065008",
            "telephone_number": "732-330-4057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "478 BURNSIDE AVE",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061082425",
            "telephone_number": "860-528-7161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YERRAGONDU",
        "first_name": "SUNIL",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-14",
        "last_updated": "2012-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "50589",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CT",
            "license": "50589",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hartford, CT

Sources for this page

Verify at the official NPI Registry.