Pavankumar Bommasamudram (NPI# 1639306293, PAC ID# 3779749478) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1639306293 |
| PAC ID by PECOS | 3779749478 |
| Professional Enrollment ID | I20120725000093 |
| Full Name | Pavankumar Bommasamudram |
| Organization Legal Name | NORTHEASTERN HEALTH SYSTEM |
| Address |
1400 E Downing St Tahlequah OK 74464-3324 |
| Phone Number | 9184560641 |
| Gender | M |
| Graduation Year | 2008 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 1456255025 |
| Number of Group Practice Members | 58 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 370089 | NORTHEASTERN HEALTH SYSTEM |
| 370037 | ST ANTHONY HOSPITAL |
| 370202 | HILLCREST HOSPITAL SOUTH |
| 370057 | MUSCOGEE (CREEK) NATION MEDICAL CENTER |
| 370171 | CHEROKEE NATION W W HASTINGS INDIAN HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1000 N Lee Ave, St Anthony Hospital, Oklahoma City, OK 73102-1036 | 4052727000 | HOSPITALIST MEDICINE PHYSICIANS OF TEXAS PLLC |
| 1111 N Dewey Ave, Bone and Joint Hospital, Oklahoma City, OK 73103-2609 | 8885635633 | HOSPITALIST MEDICINE PHYSICIANS OF TEXAS PLLC |
| 700 Ne 13th St, Oklahoma City, OK 73104-5004 | 4052714700 | QUESTCARE HOSPITALISTS OKLAHOMA LLC |
| 1401 Morris Dr, Okmulgee, OK 74447-6429 | 9187564233 | CREEK NATION HOSPITAL AND CLINICS |
| 1125 E Cleveland Ave, Sapulpa Indian Health Center, Sapulpa, OK 74066-4641 | 9182249310 | CREEK NATION HOSPITAL AND CLINICS |
| 1400 E Downing St, Tahlequah, OK 74464-3324 | 9184560641 | NORTHEASTERN HEALTH SYSTEM |
| Organization Legal Name | NORTHEASTERN HEALTH SYSTEM |
| Physicians | 54 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher Thomas Ward | Certified Registered Nurse Anesthetist (crna) | Northeastern Health System | 1400 E Downing St, Tahlequah, OK 74464-3324 |
| Anna Wanahita | Neurology | Northeastern Health System | 1373 E Boone St, Suite 2300, Tahlequah, OK 74464-3365 |
| Bilal Aziz | Nephrology | Northeastern Health System | 1400 E Downing St, Tahlequah, OK 74464-3324 |
| Diego Humphrey | Cardiovascular Disease (cardiology) | Northeastern Health System | 1400 E Downing St, Tahlequah, OK 74464-3324 |
| Florame S Jamison | Nurse Practitioner | Northeastern Health System | 1400 E Downing St, Tahlequah, OK 74464-3324 |
| Ross P Turner | Hospitalist | Northeastern Health System | 1400 E Downing St, Tahlequah, OK 74464-3324 |
| Matthew E Stiger | Emergency Medicine | Northeastern Health System | 1400 E Downing St, Tahlequah, OK 74464-3324 |
| William J Myers Jr. | General Surgery | Northeastern Health System | 1500 E Downing St, Suite 103, Tahlequah, OK 74464-3354 |
| Zackary Paul Spradlin | Emergency Medicine | Northeastern Health System | 1400 E Downing St, Tahlequah, OK 74464-3324 |
| Imran Tahir | Nephrology | Northeastern Health System | 1400 E Downing St, Tahlequah, OK 74464-3324 |
| Street Address |
1400 E DOWNING ST |
| City | TAHLEQUAH |
| State | OK |
| Zip | 74464-3324 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher Thomas Ward | Certified Registered Nurse Anesthetist (crna) | Northeastern Health System | 1400 E Downing St, Tahlequah, OK 74464-3324 |
| Bilal Aziz | Nephrology | Northeastern Health System | 1400 E Downing St, Tahlequah, OK 74464-3324 |
| Diego Humphrey | Cardiovascular Disease (cardiology) | Northeastern Health System | 1400 E Downing St, Tahlequah, OK 74464-3324 |
| Florame S Jamison | Nurse Practitioner | Northeastern Health System | 1400 E Downing St, Tahlequah, OK 74464-3324 |
| Ross P Turner | Hospitalist | Northeastern Health System | 1400 E Downing St, Tahlequah, OK 74464-3324 |
| Matthew E Stiger | Emergency Medicine | Northeastern Health System | 1400 E Downing St, Tahlequah, OK 74464-3324 |
| Zackary Paul Spradlin | Emergency Medicine | Northeastern Health System | 1400 E Downing St, Tahlequah, OK 74464-3324 |
| Imran Tahir | Nephrology | Northeastern Health System | 1400 E Downing St, Tahlequah, OK 74464-3324 |
| Sean M Scearce | Physician Assistant | Northeastern Health System | 1400 E Downing St, Tahlequah, OK 74464-3324 |
| Clinton K Roberts | Certified Registered Nurse Anesthetist (crna) | Northeastern Health System | 1400 E Downing St, Tahlequah, OK 74464-3324 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christi D Anderson | Physician Assistant | Cherokee Nation | 19600 E Ross St, Cn Outpatient Health Center, Tahlequah, OK 74464-0545 |
| James Mark Seratt | Family Medicine | 22408 Hwy 51, Tahlequah, OK 74464-2058 | |
| Megan Jean Chee | Optometry | Cherokee Nation | 16944 W Cherokee, Gadugi Health Center, Tahlequah, OK 74464-2512 |
| Barinder P Bassi | Podiatry | Cherokee Nation | 100 S Bliss Ave, Tahlequah, OK 74464-2512 |
| Charles Wayne Bingham | Family Medicine | Cherokee Nation | 100 S Bliss Ave, Tahlequah, OK 74464-2512 |
| Carolyn E Majcher | Optometry | Cherokee Nation | 100 S Bliss Ave, Tahlequah, OK 74464-2512 |
| Cathy J Fielder | Physician Assistant | Cherokee Nation | 100 S Bliss Ave, Tahlequah, OK 74464-2512 |
| Gregory S Brooks | Family Medicine | Cherokee Nation | 100 S Bliss Ave, Tahlequah, OK 74464-2512 |
| Sylvia Soto | Family Medicine | Cherokee Nation | 100 S Bliss Ave, Tahlequah, OK 74464-2512 |
| Deborah Mcalister | Orthopedic Surgery | Cherokee Nation | 100 S Bliss Ave, Tahlequah, OK 74464-2512 |
| Find all physicians in zip 74464 | |||
| City | TAHLEQUAH |
| Zip Code | 74464 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | TAHLEQUAH + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Pavankumar Bommasamudram.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.