Subramoniam Madhusoodanan, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

138957 Issued in NY

Practice address

327 B 19TH Street
Far Rockaway, NY 11691

Phone

(718) 869-7375

Fax

(718) 869-8532

NPI assigned

Oct 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

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.

• Chestnut Medical Assc PC

  • Internal Medicine Physician
  • Cedarhurst, NY
  • NPI 1760589469
  NPD (past)

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519862400000",
    "number": "1992794705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 BROADWAY",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591511",
            "telephone_number": "516-371-1804",
            "fax_number": "516-371-1804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 B 19TH STREET",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "11691",
            "telephone_number": "718-869-7375",
            "fax_number": "718-869-8532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADHUSOODANAN",
        "first_name": "SUBRAMONIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2018-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "138957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00528890",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC",
            "identifier": "40A553",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jania R Luster
• Hnin Yu Lwin
• Christine Lynch
• M&L Medical Services. P.C.
• Allyson Maclay
• Mahsa Mafee, PSYD
• Devin L Maffett
• Ravai P Mahenga, RN
• Tahmida Mahjabeen
• Blima E Majerovic, MS CCCSLP

• Psychiatry Physician in Far Rockaway, NY
• Providers in Far Rockaway, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.