NPIMap

Individual provider Active NPI

Sam Suman Nuthalapaty, M.D

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1972758787
Registry record updated May 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
049139 Issued in CT
Practice address
600 E 233Rd St
Montefiore Medical Center North Division
Bronx, NY 10466-2604
Phone
(718) 920-9000
Fax
(718) 920-9160
NPI assigned
Nov 20, 2008
Last updated
May 18, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 131740114 NY
General Acute Care Hospital 282N00000X 258371 NY
Internal Medicine Physician 207R00000X 049139 CT Primary

Addresses

Primary practice location

600 E 233Rd St
Montefiore Medical Center North Division
Bronx, NY 10466-2604

Mailing address

1217 Avalon SQ
Glen Cove, NY 11542-2876
Phone (347) 427-6848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20111108000674 CA Practitioner - Internal MedicinePractitioner - Emergency Medicine 7315134152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Emergency Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epic Medical Group,IncGroup PAC ID 4385883958, 54 clinicians

Practice addresses (Care Compare)

4940 Van Nuys Blvd
Suite 200
Sherman Oaks, CA 91403-1741
Phone (818) 528-1260

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
049139CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Epic Medical Group,Inc Internal Medicine CurrentSince May 15, 2013 Accepting new patients
St Francis Hospital United States Catholic Conference General Acute Care Hospital Past Accepting new patients

Locations

501 W Glenoaks Blvd
Ste 26
Glendale, CA 91202

4940 Van Nuys Blvd
Ste 200
Sherman Oaks, CA 91403
Phone (818) 528-1090

4955 Van Nuys Blvd
Ste 308
Van Nuys, CA 91403
Phone (818) 387-6114

16850 Bear Valley Rd
Victorville, CA 92395
Phone (760) 241-8222

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7032/brand/1/csg/1/fhir/r4
  • Direct secure messaging: soh-snuthalapaty@primehealthcare.direct-ci.com

Organizations & group practices 2

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 10

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": "1227139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305676800000",
    "number": "1972758787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 AVALON SQ",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422876",
            "telephone_number": "347-427-6848",
            "fax_number": "718-920-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E 233RD ST",
            "address_2": "MONTEFIORE MEDICAL CENTER NORTH DIVISION",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104662604",
            "telephone_number": "718-920-9000",
            "fax_number": "718-920-9160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTHALAPATY",
        "first_name": "SAM",
        "middle_name": "SUMAN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-20",
        "last_updated": "2011-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NY",
            "license": "131740114",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NY",
            "license": "258371",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "049139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.