SUNDARESAN T SAMBANDAM M.D.
NPI 1811971922
Internal Medicine - Hematology & Oncology in Cranston, RI
NPI Status: Active since December 01, 2005
Contact Information
1220 PONTIAC AVE
SUITE 101
CRANSTON, RI
ZIP 02920
Phone: (401) 943-4660
Fax: (401) 943-0240
- Individual
- Male
- Internal Medicine
- Hematology & Oncology
- PECOS Enrolled
- Medicare Quality Reporting
About SUNDARESAN SAMBANDAM
This page provides the complete NPI Profile along with additional information for Sundaresan Sambandam, an internist established in Cranston, Rhode Island with a medical specialization in Internal Medicine, focusing in hematology & oncology . The healthcare provider is registered in the NPI registry with number 1811971922 assigned on December 2005. The practitioner's primary taxonomy code is 207RH0003X with license number 05372 (RI). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1811971922
- Provider Name
- SUNDARESAN T SAMBANDAM M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1220 PONTIAC AVE SUITE 101 CRANSTON, RI 02920
- Location Phone
- (401) 943-4660
- Location Fax
- (401) 943-0240
- Mailing Address
- 455 TOLL GATE RD WARWICK, RI 02886
- Mailing Phone
- (401) 273-0641
- Mailing Fax
- (401) 943-0240
- Is Sole Proprietor?
- No
- Enumeration Date
- 12-01-2005
- Last Update Date
- 08-15-2024
- Code Navigator
An internist like Sundaresan Sambandam is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Hematology & Oncology
- Taxonomy Code
- 207RH0003X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 05372
- License State
- RI
- Taxonomy Description
- An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 001994 | OTHER (01) | RI | BLUECHIP/RIBCBS |
| 005372 | OTHER (01) | TUFTS HP | |
| 720024001 | OTHER (01) | CIGNA | |
| RI0007390 | OTHER (01) | TRICARE | |
| 0513005 | OTHER (01) | US HEALTHCARE | |
| 0000002589 | OTHER (01) | RI | BC/BS OF RI |
| 30-00050 | OTHER (01) | RI | UHC OF NE,INC |
| 4549333 | OTHER (01) | AETNA | |
| 0173690 | MEDICAID (05) | MA | |
| 7003434 | MEDICAID (05) | RI | |
| 2376 | OTHER (01) | RI | NEIGHBORHOOD HEATH PLAN |
| 9475RIH | OTHER (01) | HARVARD PILGRIM HP |
Medicare Participation & PECOS Enrollment Status
Sundaresan Sambandam is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE017N)
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) (HCPCS:A4221)
1 DME suppliers used 13 Medicare Claims 53 Services Paid
DME-Other DME (DE000N)
Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each (HCPCS:K0552)
1 DME suppliers used 13 Medicare Claims 52 Services Paid
Unknown
Treatment-Injections and Infusions (nononcologic) (RI008N)
Injection, immune globulin (cuvitru), 100 mg (HCPCS:J1555)
1 DME suppliers used 13 Medicare Claims 3640 Services Paid
Treatment-Injections and Infusions (nononcologic) (RI008N)
Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg (HCPCS:J1569)
1 DME suppliers used 16 Medicare Claims 960 Services Paid
Treatment-Treatment - Miscellaneous (RX029N)
Capecitabine, oral, 500 mg (HCPCS:J8521)
1 DME suppliers used 13 Medicare Claims 728 Services Paid
Treatment-Chemotherapy (RH012N)
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period (HCPCS:Q0511)
2 DME suppliers used 11 Medicare Claims 11 Services Paid
Treatment-Chemotherapy (RH012N)
Services, supplies and accessories used in the home under the medicare intravenous immune globulin (ivig) demonstration (HCPCS:Q2052)
1 DME suppliers used 16 Medicare Claims 16 Services Paid
Orthotic Devices
DME-Orthotic Devices (DF000N)
Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type (HCPCS:L8000)
2 DME suppliers used 18 Medicare Claims 35 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
New patient office or other outpatient visit, 60-74 minutes
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 409 times for 224 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 244 times for 165 patientsThis service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
This service was performed 28 times for 28 patientsThis is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
This service was performed 25 times for 25 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 02920 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99205
- Average New Patient Price $177.03
- Minimum New Patient Price $58.57
- Maximum New Patient Price $177.03
- Average New Patient Copayment $44.25
- Minimum New Patient Copayment $14.64
- Maximum New Patient Copayment $44.25
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $103.1
- Minimum Established Patient Price $18.92
- Maximum Established Patient Price $144.38
- Average Established Patient Copayment $25.77
- Minimum Established Patient Copayment $4.73
- Maximum Established Patient Copayment $36.09
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Anticoagulant Management Improvements | Yes | N/A |
| Individual MIPS eligible clinicians and groups who prescribe oral Vitamin K antagonist therapy (warfarin) must attest that, for 60 percent of practice patients in the transition year and 75 percent of practice patients in Quality Payment Program Year 2 and future years, their ambulatory care patients receiving warfarin are being managed by one or more of the following improvement activities: • Patients are being managed by an anticoagulant management service, that involves systematic and coordinated care, incorporating comprehensive patient education, systematic prothrombin time (PT-INR) testing, tracking, follow-up, and patient communication of results and dosing decisions; • Patients are being managed according to validated electronic decision support and clinical management tools that involve systematic and coordinated care, incorporating comprehensive patient education, systematic PT-INR testing, tracking, follow-up, and patient communication of results and dosing decisions; • For rural or remote patients, patients are managed using remote monitoring or telehealth options that involve systematic and coordinated care, incorporating comprehensive patient education, systematic PT-INR testing, tracking, follow-up, and patient communication of results and dosing decisions; and/or • For patients who demonstrate motivation, competency, and adherence, patients are managed using either a patient self-testing (PST) or patient-self-management (PSM) program. | ||
| Care Plan | 100% | 563 |
| Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan | ||
| Diabetes screening | Yes | N/A |
| Diabetes screening for people with schizophrenia or bipolar disease who are using antipsychotic medication. | ||
| Documentation of Current Medications in the Medical Record | 100% | 2553 |
| Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| e-Prescribing | 24% | 211 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Implementation of improvements that contribute to more timely communication of test results | Yes | N/A |
| Timely communication of test results defined as timely identification of abnormal test results with timely follow-up. | ||
| Medication Reconciliation | 100% | 130 |
| The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
| Oncology: Medical and Radiation - Pain Intensity Quantified | 100% | 459 |
| Percentage of patient visits, regardless of patient age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy in which pain intensity is quantified | ||
| Pain Assessment and Follow-Up | 100% | 2121 |
| Percentage of visits for patients aged 18 years and older with documentation of a pain assessment using a standardized tool(s) on each visit AND documentation of a follow-up plan when pain is present | ||
| Patient-Specific Education | 100% | 1060 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 82% | 604 |
| Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user | ||
| Provide Patient Access | 1% | 1060 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Secure Messaging | 1% | 1060 |
| For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Tobacco use | Yes | N/A |
| Tobacco use: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including tobacco use screening and cessation interventions (refer to NQF #0028) for patients with co-occurring conditions of behavioral or mental health and at risk factors for tobacco dependence. | ||
| Use of High-Risk Medications in the Elderly | 1% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 661 |
| Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication | ||
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1811971922, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 68 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 11 providers are registered at the same or a nearby location.
CRANSTON, RI 02920
CRANSTON, RI 02920
CRANSTON, RI 02920
CRANSTON, RI 02920
CRANSTON, RI 02920
CRANSTON, RI 02920
CRANSTON, RI 02920
CRANSTON, RI 02920
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1811971922, enumerated as an "individual" on December 01, 2005.
The provider is located at 1220 PONTIAC AVE SUITE 101 CRANSTON, RI 02920 and the phone number is (401) 943-4660.
Internal Medicine with taxonomy code 207RH0003X and a focus in Hematology & Oncology.
The provider might be accepting Accepts: Blue Cross Blue Shield, Medicare, Medicaid, Tufts. Please consult your insurance carrier or call the provider to verify.
