NPIMap

Individual provider Active NPI

Annapurneswara Rao Chimpiri, MD

  • Diagnostic Radiology Physician
  • Stony Brook, NY
National Provider Identifier
1962504167
Registry record updated Jun 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
066768 Issued in GA
Practice address
HSC L4 RM 120
Stony Brook, NY 11794-8460
Phone
(631) 444-5400
Fax
(631) 444-7538
NPI assigned
Sep 1, 2006
Last updated
Jun 6, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 25131 OK
Diagnostic Radiology Physician 2085R0202X 066768 GA Primary

Addresses

Primary practice location

HSC L4 RM 120
Stony Brook, NY 11794-8460

Mailing address

HSC Level 4 RM 120
Stony Brook, NY 11794-8460
Phone (631) 444-5400

Other identifiers 5

IdentifierTypeStateIssuer
52601605 001OtherGABCBSGA
P01171167OtherGARAILROAD MEDICARE
003132709AMedicaidGA
003132709BMedicaidGA
52601605 002OtherGABCBSGA

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
I20140619000572 NY Practitioner - Diagnostic Radiology 5294735817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1995
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

State licenses

LicenseStateTypeSpecialty
25131OKMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Radiology, University Faculty Practice Corporation Diagnostic Radiology CurrentSince Jun 1, 2014 Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: annapurneswara.chimpiri@direct.stonybrookmedicine.edu

Organizations & group practices 1

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 11

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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402012800000",
    "number": "1962504167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HSC LEVEL 4 RM 120",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948460",
            "telephone_number": "631-444-5400",
            "fax_number": "631-444-7538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HSC L4 RM 120",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948460",
            "telephone_number": "631-444-5400",
            "fax_number": "631-444-7538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIMPIRI",
        "first_name": "ANNAPURNESWARA",
        "middle_name": "RAO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2014-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OK",
            "license": "25131",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "066768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSGA",
            "identifier": "52601605  001",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01171167",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003132709A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003132709B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSGA",
            "identifier": "52601605  002",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.