Sumon Bhattacharyya
Individual provider Active NPI Internal Medicine Physician · Fort Drum, NY
NPI 1972246387 · NPPES record last updated Aug 16, 2025
Key facts
- NPI
- 1972246387
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 0101281256 (VA)
- Practice address
- 11050 Mount Belvedere Blvd
Fort Drum, NY 13602-5438 - Phone
- (315) 772-7059
- NPI assigned
- Apr 14, 2022
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250130000208 | VA | Order and Referring Only - Internal Medicine |
8325577786 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101281256 | VA | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0101281256 | VA | Yes |
Addresses
Primary practice location
11050 Mount Belvedere Blvd
Fort Drum, NY 13602-5438
Mailing address
11050 Mount Belvedere Blvd
Fort Drum, NY 13602-5438
Phone (315) 772-7059
Other providers in Fort Drum, NY
- Todd L. Benham
- Dianna L Bennett
- Jamie Michael Bennett
- Kayla Christine Bentz
- Erhard Alfred Beuttenmuller
- Mary Bice
- Randall Alan Bischoff
- Kabita Bista
- Robert Garfield Blackstock
- Richard C. Blunden
All providers in Fort Drum, NY · Internal Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 16, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.