Balasasikumar Sundaram, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

E4251 Issued in AR

Practice address

1001 Towson Ave
Fort Smith, AR 72901-4921

Phone

(479) 441-5011

Fax

(479) 441-4932

NPI assigned

May 8, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

Emergency Medicine

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic Fort Smith CommunitiesGroup PAC ID 3870668510, 361 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Mercy Clinic Fort Smith Communities

  • Multi-Specialty Clinic/Center
  • Fort Smith, AR
  • NPI 1902073620
  Medicare reassignment Care Compare group NPD
• South Arkansas Emergency Physicians LLP

  • Emergency Medicine Physician
  • El Dorado, AR
  • NPI 1942435458
  Medicare reassignment NPD
• Ies Arkansas PLLC

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1598488090

  AR

  Medicare reassignment NPD
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  AR

  Medicare reassignment NPD
• Mercy Clinic Fort Smith Communities

  • Endocrinology, Diabetes & Metabolism Physician
  • Fort Smith, AR
  • NPI 1790258002
  NPD
• South Arkansas Emergency Physicians, LLP

  • Emergency Medicine Physician
  • Siloam Springs, AR
  • NPI 1225452055
  NPD
• Mercy Clinic Fort Smith Communities

  • Urgent Care Clinic/Center
  • Fort Smith, AR
  • NPI 1134425721
  NPD (past)
• Mercy Hospital Fort Smith

  • General Acute Care Hospital
  • Fort Smith, AR
  • NPI 1568433480
  NPD (past)
• River Valley Urgent Care PA

  • Medical Specialty Clinic/Center
  • Fort Smith, AR
  • NPI 1619133394
  NPD (past)
• University of Wyoming

  dba Albany Community Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Laramie, WY
  • NPI 1639617061
  NPD (past)

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

• Mercy Hospital Fort Smith

  • General Acute Care Hospital
  • Fort Smith, AR
  • NPI 1568433480
  Care Compare affiliation

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1922057900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1543 FIANNA PLACE TER",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729088582",
            "telephone_number": "479-648-6714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 TOWSON AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729014921",
            "telephone_number": "479-441-5011",
            "fax_number": "479-441-4932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDARAM",
        "first_name": "BALASASIKUMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E4251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS STATE LICENSE",
            "identifier": "E4251",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "156990001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200117580A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany N Sullivan
• Chasity Renae Sullivan, APRN
• Eric Scott Sullivan, DO
• Ryan Sullivan, D.O.
• Mari Sumbler
• Vikki L Sutterfield, MD
• Jennifer L Sutton
• Katlyn Sutton, QBHP
• Laci Sutton
• Jessica Nicole Swaim

• Emergency Medicine Physician in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Emergency Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.