SUDHA SUBRAMANYAM MD
NPI 1104481555
Family Medicine in Nampa, ID
About Sudha Subramanyam Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SUDHA SUBRAMANYAM MD (NPI 1104481555) is an individual family medicine provider in Nampa, Idaho, licensed in Idaho (M15981) and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS, is affiliated with St Luke's Regional Medical Center, and maintains a secondary practice location in Nampa.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Sudha Subramanyam Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Sudha Subramanyam reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Boise, ID 83704
- Reassigned Medicare billing, Idaho enrollment
- 152 clinicians in this Medicare group
Boise, ID 83712
- Reassigned Medicare billing, Idaho enrollment
- 1,312 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 4
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
St Luke's Regional Medical Center
Acute Care Hospitals · Boise, IDSt Luke's Nampa Medical Center
Acute Care Hospitals · Nampa, IDPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 83687 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Referred Medical Equipment & Supplies CMS DME claims 2
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
NAMPA, ID 83687
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Sudha Subramanyam's NPI number?
The NPI number for Sudha Subramanyam is 1104481555. It was assigned to this individual provider in the NPPES registry on May 1, 2019.
Where is Sudha Subramanyam located?
Sudha Subramanyam practices at 9850 W St Lukes Dr, Nampa, ID 83687. The listed phone number is (208) 205-7282.
What is Sudha Subramanyam's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Sudha Subramanyam enrolled in Medicare?
Yes. Sudha Subramanyam is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Sudha Subramanyam's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Sudha Subramanyam reassigns Medicare benefits to 2 organizations: Full Circle Health, Inc. (Boise, ID) and St Lukes Clinic-Treasure Valley LLC (Boise, ID). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sudha Subramanyam's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Sudha Subramanyam accept?
Health plans from PacificSource Health Plans list Sudha Subramanyam as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Sudha Subramanyam affiliated with any hospitals?
According to CMS data, Sudha Subramanyam is affiliated with St Luke's Regional Medical Center and St Luke's Nampa Medical Center.
When was this NPI record last updated?
The NPPES record for Sudha Subramanyam was last updated on June 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Sudha Subramanyam, MD · NPI 1104481555
Family Medicine physician in Nampa, Idaho. Individual provider, active in the CMS NPPES registry since May 1, 2019.
## Identity
- **NPI:** 1104481555 (Entity type: Individual)
- **Enumerated:** May 1, 2019
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** M15981 (Idaho)
- **Sole proprietor:** No
## Practice location
- **Address:** 9850 W ST LUKES DR, Nampa, ID 83687-7912
- **Phone:** (208) 205-7282
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Full Circle Health, Inc. (NPI 1841490075, Boise, ID); St Lukes Clinic-Treasure Valley LLC (NPI 1326336058, Boise, ID) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2009
## Record status
- **NPPES last updated:** June 6, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1104481555) · Data from the CMS NPPES public registry.