Baskaran Sundaram, MB, BS

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD450483 Issued in PA

Practice address

111 S 11TH St
Suite 3390
Philadelphia, PA 19107-4824

Phone

(215) 955-6226

Fax

(215) 923-1562

NPI assigned

Oct 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA, NJ2 enrollments

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 2

Specialty

Diagnostic Radiology

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Jefferson University Physicians of New Jersey PCGroup PAC ID 9931325131, 117 clinicians

Jefferson University Radiology Associates LLCGroup PAC ID 7315845708, shared by 3 NPIs, 110 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174
• Jefferson Abington Hospital Hospital, Abington, PA, CCN 390231
• Jefferson Health- Northeast Hospital, Philadelphia, PA, CCN 390115
• Jefferson Lansdale Hospital Hospital, Lansdale, PA, CCN 390012
• Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science, 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 and National Provider Directory roles.

• Jefferson University Physicians

  • General Practice Physician
  • Philadelphia, PA
  • NPI 1326093675

  Diagnostic Radiology

  Medicare reassignment Care Compare group NPD
• Jefferson University Physicians of New Jersey, P.C.

  • Internal Medicine Physician
  • Voorhees, NJ
  • NPI 1083039200
  Medicare reassignment Care Compare group NPD
• Jeanes Radiology Associates LLC

  • Diagnostic Radiology Physician
  • Philadelphia, PA
  • NPI 1639110240
  Medicare reassignment NPD
• Jefferson University Radiology Associates LLC

  • Radiology Clinic/Center
  • Philadelphia, PA
  • NPI 1578512224

  Diagnostic Radiology

  Medicare reassignment NPD
• Lebanon Diagnostic Imaging, LLC

  • Diagnostic Radiology Physician
  • Chambersburg, PA
  • NPI 1346246436
  Medicare reassignment NPD
• Rittenhouse Imaging Center, LLC

  • Diagnostic Radiology Physician
  • Bryn Mawr, PA
  • NPI 1962458034
  Medicare reassignment NPD
• Jefferson University Radiology Associates, LLC

  • Radiology Clinic/Center
  • Marlton, NJ
  • NPI 1972169902

  Diagnostic Radiology

  Medicare reassignment NPD
• Jefferson University Radiology Associates, LLC

  • Radiology Clinic/Center
  • Philadelphia, PA
  • NPI 1063067635

  Diagnostic Radiology

  NPD
• Insight Health Corp

  • Physiological Laboratory
  • Wilkes Barre, PA
  • NPI 1174647267
  NPD (past)

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

• Jefferson Health - Northeast

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1801963343
  Care Compare affiliation Name & address match
• Abington Memorial Hospital

  • General Acute Care Hospital
  • Abington, PA
  • NPI 1811992084
  Care Compare affiliation
• Lansdale Hospital Corporation

  • General Acute Care Hospital
  • Lansdale, PA
  • NPI 1386896306
  Care Compare affiliation
• Thomas Jefferson University Hospitals Inc

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1215916002
  Care Compare affiliation
• Kennedy University Hospital Inc.

  • General Acute Care Hospital
  • Stratford, NJ
  • NPI 1386746592
  Care Compare affiliation

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396310400000",
    "number": "1972684959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "address_2": "SUITE 3390",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "address_2": "SUITE 3390",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-6226",
            "fax_number": "215-923-1562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDARAM",
        "first_name": "BASKARAN",
        "name_prefix": "Dr.",
        "credential": "MB, BS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2014-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301081071",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD450483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4507375",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Derek Richard Sundermann, M.D.
• Samantha Sundermeier, DO

• Diagnostic Radiology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Diagnostic Radiology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2014; 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.