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SOURYA RANJAN MAHAPATRA M.D. NPI 1457448086


NPI Information

NPI: 1457448086
Provider Name: SOURYA RANJAN MAHAPATRA, M.D.
Classification: Internal Medicine - 207RG0300X
Entity Type: Individual

Specialization: Geriatric Medicine

Organization: VANTAGE HEALTHCARE LLC

PECOS Registration: Yes

Address:
NASHUA CENTER FOR HEALTHY AGING
280 MAIN ST., #210A
NASHUA, NH
ZIP 03060
Phone: (603) 577-3080
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Sourya Ranjan Mahapatra, M.D. is a geriatric medicine internal medicine in Nashua, NH with 30 years of experience. The provider is an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. Sourya Ranjan Mahapatra, M.D. NPI is 1457448086. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

NASHUA CENTER FOR HEALTHY AGING
280 MAIN ST., #210A
NASHUA, NH
ZIP 03060
Phone: (603) 577-3080

The NPI 1457448086 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/6/2006 and was last updated on 4/5/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RG0300XInternal MedicineGeriatric Medicine12394NEW HAMPSHIREYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
130204441MEDICAIDNEW HAMPSHIRE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.