Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Roy Subash Kondapavuluru, MD

Individual provider Internal Medicine Physician · NPI 1003546565

Roy Subash Kondapavuluru, MD is an Internal Medicine in Staten Island, New York. Qualified in 2017, 9 years ago. Practices with North Shore-Lij Medical PC, a 6,350-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
9
Licensed in
NY
In the registry since
2022
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

475 Seaview Ave
Staten Island, NY 10305-3436
Phone: (615) 708-2623
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 338404-01 (NY)

Record details

NPI number1003546565
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJune 15, 2022
Last updated in NPPESNovember 15, 2025
Certification dateNovember 15, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Also practisesHOSPITALIST
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice North Shore-Lij Medical Pc — 6350 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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