NPIMap

Individual provider Active NPI

Nina Sundaram, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • New York, NY
National Provider Identifier
1982862298
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
254592-1 Issued in NY
Practice address
54 W 21St St RM 907
New York, NY 10010-7332
Phone
(917) 423-2925
Fax
(646) 846-3654
NPI assigned
May 23, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 254592-1 NY Primary

Addresses

Primary practice location

54 W 21St St RM 907
New York, NY 10010-7332

Mailing address

317 E 34TH St
5TH Floor
New York, NY 10016-4974
Phone (212) 726-7462

Other identifiers 2

IdentifierTypeStateIssuer
03734205MedicaidNY
A400128051OtherNYMEDICARE PTAN

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
I20101119000747 NY Practitioner - EndocrinologyPractitioner - Internal Medicine 5496941171 Reassigns benefits to 2 organizations
Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

54 W 21St St
RM 907
New York, NY 10010-7332
Phone (917) 423-2925

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
254592-1NYMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Jan 1, 2019 Accepting new patients
Nina Sundaram MD PLLC Endocrinology, Diabetes & Metabolism CurrentSince Dec 8, 2021 Accepting new patients
Optum Medical Care, P.C. Endocrinology, Diabetes & Metabolism CurrentSince Jan 1, 2019 Accepting new patients
Maple Medical, LLP Past Accepting new patients

Locations

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

317 E 34th St
New York, NY 10016
Phone (212) 263-9741

54 W 21st St
Rm 907
New York, NY 10010
Phone (917) 423-2925

317 E 34th St
Fl 5
New York, NY 10016
Phone (212) 263-6062

317 E 34th St
Fl 9
New York, NY 10016
Phone (212) 726-7400

Philadelphia, PA 19195

Interoperability endpoints

  • Direct secure messaging: nina.sundaram@608586456956932.direct.elationemr.com

Organizations & group practices 4

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.

Hospital & facility affiliations 7

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": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1982862298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 E 34TH ST",
            "address_2": "5TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100164974",
            "telephone_number": "212-726-7462",
            "fax_number": "212-981-7290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 W 21ST ST RM 907",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100107332",
            "telephone_number": "917-423-2925",
            "fax_number": "646-846-3654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDARAM",
        "first_name": "NINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-23",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "254592-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03734205",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "A400128051",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.