NPIMap

Individual provider Active NPI

Sapan K Polepalle, MD

  • Urology Physician
  • Bronx, NY
National Provider Identifier
1912954009
Registry record updated Mar 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
239371 Issued in NY
Practice address
2940 Grand Concourse
Suite 1a
Bronx, NY 10458-2611
Phone
(718) 684-2516
Fax
(718) 684-2518
NPI assigned
May 27, 2006
Last updated
Mar 30, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 239371 NY Primary

Addresses

Primary practice location

2940 Grand Concourse
Suite 1a
Bronx, NY 10458-2611

Mailing address

PO Box 2157
Monroe, NY 10949-7157
Phone (845) 346-5815

Other identifiers 1

IdentifierTypeStateIssuer
02753693MedicaidNY

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
I20060626000067 NY Practitioner - Urology 2163492620 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Northwestern University Feinberg Medical School, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adirondack Medical CenterGroup PAC ID 9638081284, 85 clinicians

Practice addresses (Care Compare)

2233 State Route 86
Saranac Lake, NY 12983-5644
Phone (518) 891-4141

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.57 of 100Reported as group
Promoting interoperability
100
Improvement activities
40
Cost
75.22

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Medical Professionals PLLC Urology CurrentSince Apr 13, 2009 Accepting new patients
Integrated Medical Professionals PLLC Urology CurrentSince Apr 13, 2009 Accepting new patients
Hudson Valley Lithotripsy Associates, P.C. Urology CurrentSince Aug 1, 2023 Accepting new patients
Wyckoff Heights Medical Center Current Accepting new patients
Wyckoff Medical Services, P C Past Accepting new patients

Locations

9010 Strada Stell Ct
Ste 103
Naples, FL 34109
Phone (800) 669-7744

480 Hicksville Rd
Bethpage, NY 11714
Phone (516) 796-2222

1870 Grand Concourse
Bronx, NY 10457
Phone (718) 294-5588

2940 Grand Concourse
Apt 1A
Bronx, NY 10458
Phone (718) 365-1100

374 Stockholm St
Brooklyn, NY 11237
Phone (718) 963-6485

340 Broadhollow Rd
Farmingdale, NY 11735
Phone (516) 931-0041

101 S Central Ave
Hartsdale, NY 10530
Phone (516) 461-2428

27005 76th Ave
North New Hyde Pk, NY 11040

3111 New Hyde Park Rd
North New Hyde Pk, NY 11042
Phone (516) 365-2300

4100 Duff Pl
#A
Seaford, NY 11783
Phone (516) 520-8080

Networks

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

Interoperability endpoints

  • Direct secure messaging: sapanpolepalle@imppllc.allscriptsdirect.net
  • Direct secure messaging: sapanpolepalle@whmc.allscriptsdirect.net
  • Direct secure messaging: spolepalle19930@sbhny.direct-ci.net

Organizations & group practices 7

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": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333065600000",
    "number": "1912954009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2157",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109497157",
            "telephone_number": "845-346-5815",
            "fax_number": "718-684-2518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 GRAND CONCOURSE",
            "address_2": "SUITE 1A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104582611",
            "telephone_number": "718-684-2516",
            "fax_number": "718-684-2518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLEPALLE",
        "first_name": "SAPAN",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2012-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "239371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02753693",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.